Background: Epicardial adipose tissue (EAT) is a type of visceral fat located between the heart and pericardium, affecting vascular smooth muscle activity through chemical secretion. It is a risk factor for cardiovascular metabolic issues and may relate to hypertension (HT). Objective: To assess the correlation between EAT thickness and HT in individuals with and without left ventricular hypertrophy (LVH).Patients and Methods: This observational study included 105 individuals with HT, defined as having a systolic blood pressure of ≥140 mm Hg, a diastolic pressure of ≥90 mm Hg, or being on antihypertensive medication, and 30 healthy controls. Participants underwent transthoracic echocardiography to measure left ventricle dimensions and EAT thickness. Results: Positive correlations were found between EAT thickness and several cardiac structural and functional parameters (Left ventricular mass index (LVMI), the ratio of early mitral inflow velocity to mitral annular early diastolic velocity (E/'e ratio), etc.), with a significant correlation between EAT thickness and both LVMI and E/'e ratio. EAT thickness above 5.25 mm predicted LVH in HT patients with 85.7% sensitivity, 82.1% specificity, and 83.9% accuracy. Conclusions: Compared to hypertensive patients without hypertrophy and healthy individuals, hypertensive patients with LVH had a much thicker EAT. Based on the findings, EAT may be a useful marker for HT ventricular remodeling and hypertrophy.