OBJECTIVE To assess the relationship between microalbuminuria and left ventricular hypertrophy in patients with essential hypertension. METHODS The case-control study was conducted at Al-Yarmouk Teaching Hospital, Baghdad, Iraq, from June 1 to December 31, 2016, and comprised patients with essential hypertension. Based on echocardiography, the patients were divided into 2 equal groups of those with and without left ventricular hypertrophy. Spot urine sample for the patients in the 2 groups was collected to assess microalbuminuria. Blood pressure, smoking status, family history of hypertension, serum creatinine, total cholesterol and blood sugar levels were evaluated. SPSS 22 was used for data analysis. RESULTS Of the 100 subjects, 47(47%) were males and 53(53%) were females. The overall mean age was 59}7.2 years. The case and control groups had 50(50%) patients each. The mean albumin-to-creatinine ratio of the patients was 70.5}4.6μg/mg compared to 30.3}16.6μg/mg of the controls (p<0.05). The mean systolic blood pressure of patients with microalbuminuria was 163.6}10.5 mmHg, mean diastolic blood pressure was 104.7}7.3mmHg, and mean albumin-to-creatinine ratio was 74}43μg/mg compared to 157.1}0.2mmHg, 96.5}6.8mmHg and 23}13μg/mg, respectively, in patients without microalbuminuria (p<0.05 each). CONCLUSIONS There was found a positive relationship between left ventricular hypertrophy and microalbuminuria in patients with essential hypertension.