Aim To observe whether the new electrocardiogram (ECG) diagnostic criteria RLⅠ+SV4 and SD+SV4 are suitable for the diagnosis of hypertension complicated with left ventricular hypertrophy (LVH), and to study the clinical value of 13 ECG diagnostic criteria and the combined application of new and commonly used criteria for hypertension complicated with LVH. Methods Using the left ventricular mass index (LVMI) measured by echocardiography as the standard, 280 inpatients with essential hypertension or a history of hypertension treatment were selected, including 94 patients with hypertension complicated with LVH (LVH group), 186 patients with normal ventricle (normal left ventricle group). 12-lead ECG is recorded simultaneously. Receiver operating characteristic curve (ROC) for various ECG diagnostic criteria was plotted and the area under curve (AUC) of the ROC was compared. The sensitivity and specificity of various diagnostic criteria were calculated. The diagnostic value of RLⅠ+SV4, SD+SV4 and RLⅠ+SV4, SD+SV4 combined with the currently recognized ECG diagnostic criteria for hypertensive patients with LVH was analyzed. Results In a single ECG lead, RLⅠ, the R wave in lead Ⅰ, was one of the better predictors of LVH (AUC＝0.63, P＜0.01). In the study of the sum of the amplitudes of the two leads for the diagnosis of LVH, the sensitivity of the RLⅠ+SV4 standard (AUC＝0.64, P＜0.01) was 50%, and the specificity was 71%; Paired chi-square test showed no significant difference between RLⅠ+SV4 diagnosis of LVH and the gold standard (LVMI to determine LVH). The SD+SV4 standard (AUC＝0.59, P＜0.05) had a sensitivity of 31% and a specificity of 87%, in which the SD wave was the S wave with the largest amplitude in the 12 leads. RLⅠ+SV4 combined with Sokolow-Lyon voltage standard could improve the sensitivity of diagnosing hypertension complicated with LVH, the sensitivity was 59%, and the specificity was 60%. Conclusions RLⅠ+SV4 standard has higher AUC, which is suitable for the initial screening of hypertensive patients with LVH; RLⅠ+SV4 combined with Sokolow-Lyon voltage standard can improve the sensitivity of diagnosis. The clinical applicability of SD+SV4 standard is not as high as that of RLⅠ+SV4 standard.