Background: Hypertensive heart disease (HHD) and coronary artery disease (CAD) generally develop left ventricular remodeling. Therefore, it is of great importance for how to assess HHD and CAD's left ventricular remodeling which can influence vital diagnosis, therapeutic decisions and prognosis. Aim of the Work: to assess left ventricular remodeling index in HTN patients compared to normal patients using 2D and 3D transthoracic echocardiography. Patients and Methods: This study included 120 subjects at Cardiology Department, Faculty of Medicine, Al-Azhar University during the period from October 2018 to June 2019. They were divided into two groups: Group A (Patient group): which included (100) hypertensive patient. Group B (Control group): which included (20) age and sex matched apparently healthy individuals. Results: There were no significant differences in age and sex inter-group. LVRI detected by RT3DE and 2DE showed significant differences inter-group (1.72±0.04 vs 1.94±0.07, 1.73±0.04 vs 2.17±0.05); and significant differences in patient (1.94±0.07 vs 2.17±0.05), but no significant differences in control group (1.72±0.04 vs 1.73±0.04). Correlation analysis indicated that there was a good positive correlation between LVRI detected by RT3DE and 2DE in control and patient groups (r=0.91, 0.79, all P<0.001). Conclusion: LVRI derived from RT3DE can provide more superiority to LVRI derived from 2DE as an index for evaluating left ventricular remodelling.