Background: Essential hypertension (EH) is the most well-known cardiovascular illness. It is estimated that (30% - 40%) of blood pressure (BP) is caused by genetic factor. Objectives: to investigate the relation between 11 beta hydroxysteroid dehydrogenase type 1) 11β-HSD1 (gene polymorphism and EH in patients attending Zagazig University Hospitals. Methods: Thirty-one patients having EH and the control group of thirty-one apparently healthy individuals. 11β-HSD1 gene polymorphism (rs45487298) was analyzed by restriction fragment length polymorphism reaction. Results: we found that A allele was significantly higher in hypertension (HTN) group and Subjects carrying A allele had a higher incidence to have HTN (OR = 2.5, 95 % CI = 1.04–5.8 and P = 0.04). Levels of TG, and total cholesterol, were significantly higher and levels of HDL cholesterol were significantly lower in A/A than in wtwt genotype. Also A allele and triglycerides are independent risk factor for EH development. Conclusion: there was a significant relation between 11β-HSD1 gene polymorphism and EH.