Abstract: Background Whether serum uric acid are related with ischemic stroke in essential hypertension （EH） is controversial. Objective To delineate the relationship between serum uric acid and ischemic stroke in EH. Methods A retrospective study was conducted in a cohort of 729 EH patients. Patients were classified into four groups according to serum uric acid level. The odds ratio for ischemic stroke was calculated with the lowest quartile as the reference. Results The prevalence of ischemic stroke in EH with quartile 4 of uric acid was higher than that in EH with quartile 1（37.9% vs 17.6%,P＜0.05）,but little difference was found in the morbidity of ischemic stroke between EH with quartile 2,3. Similar trend was observed in male EH patients（P=0.037）,but not in female patients （P=0.385）; after the adjustment for the related risk factors,logistic multiple regression analysis showed that in EH with quartile 4 of uric acid,the odds ratio of ischemic stroke was 1.5 （95% CI,1.2-1.8,P＜0.01） greater than that in EH with quartile 1. This trend was also found in male,but not in female. Conclusion Elevated uric acid is an independent risk factor for ischemic stroke in male with EH.