Aim To explore the relationship of left-ventricle hypertrophy (LVH), ventricular arrhythmia and heart rate variability (HRV) in patients with essential hypertension(EH). Methods A total of 94 patients were divided into two groups: EH without LVH (control group, n=47), and EH with LVH (LVH group, n=47). The structure and function of hearts were observed through cardio B-ultrasound. The ventricular premature beats and the parameters of HRV in every time-span were observed through 24 hours holter monitoring electrocardiogram. Results Both of the incidence and grades of ventricular premature beats for 24 hours in LVH group are obviously higher than that in control group (P=0.000). The parameters of HRV were not significantly different between two groups (p>0.05). The independent risks of the grades of ventricular premature beats are the interventricular septum (IVS) thickness, the left ventricular end-diastolic dimension (LVDd) and age of patients (p<0.05, p<0.001, p<0.05; respectively). Conclusion The incidence of severe ventricular arrhythmia in EH patients with LVH raises obviously, but no correlativity exists between LVH and HRV. IVS, LVDd, and age are the independent risk factors of ventricular arrhythmia in EH patients.