Abstract: Objective To investigate the correlation between fatty liver index（FLI） and left ventricular mass index（LVMI） in subjects with essential hypertension（EH） and normotensives（non-EH, blood pressure＜140/90 mm Hg without treatment）. Methods Between January 2016 and March 2018, a total of 511 cases of hypertensives and 312 normotensives from the outpatient and inpatient departments of the First Hospital of Fujian Medical University were retrospectively analyzed. Using triglycerides, body mass index（BMI）, γ-glutamyltransferase（γ-GGT）, and waist circumference（WC）, FLI was calculated as: FLI=e^{0.953 lg triglycerides（TG）+0.139 BMI+0.718 lgγ-GGT+0.053×WC-15.745}/(1+e^{0.953×lg TG+0.139×BMI+0.718×lgγ-GGT+0.053×WC-15.745})×100. LVMI was determined by Doppler echocardiography. Subgroup analysis was performed by left ventricular hypertrophy（LVH）, age, BMI and FLI level in the hypertensive and normotensive populations. Results The age （60.2±9.6） vs（53.8±10.2） years, t=-4.031, P＜0.001;（64.2±11.7） vs（60.5±12.5） years, t=-3.261, P＜0.001, systolic blood pressure （119.2±11.1）vs（116.5±11.3） mm Hg, t=-1.530, P=0.127;（142.4±20.0） vs（136.7±17.1） mm Hg, t=-3.202, P＜0.001 and LVMI （117.1±23.9） vs（81.9±13.8） g/m~2, t=-9.882, P＜0.001;（125.7±27.0） vs（88.7±13.6） g/m~2, t=-17.221, P＜0.001 of the patients with LVH were higher than those without LVH in both hypertensives and normotensives. There was no significant difference in the FLI 23.02（15.52-43.13） vs 18.98（9.50-42.38）, U=1.134, P=0.257; 33.35（18.35-56.01） vs 39.28（19.53-58.76）, U=-1.446, P=0.148 level between the two groups. Among the normotensives and hypertensives, subjects with combined LVH showed higher age, systolic blood pressure, and LVMI than those without combined LVH（all P＜0.05）. FLI were not statistically significant between both groups（both P＞0.05）. Stratified analysis by age revealed that LVMI levels were higher in the elderly group（≥60 years） than in the young and middle-aged group（＜60 years, P＜0.05）. In hypertensives, the FLI in olderly group was lower than that in middle-aged grop 33.83（18.30-56.17） vs 40.94（22.52-62.09）, U=-2.446, P=0.014. Stratified analysis by BMI revealed that FLI and LVMI in the overweight obese group（BMI≥ 24 kg/m~2） were higher than those of the normal body mass group（BMI＜24 kg/m~2）（all P＜0.05）. In normotensives, LVMI in the FLI≥30 group was significantly higher than that in the FLI＜30 group （92.0±22.1） vs（84.6±18.6）g/m~2, t=-3.158, P=0.002. Multivariate stepwise linear regression analysis indicated that FLI, age, smoking, and heart rate were the influence factors of LVMI for normotensives（all P＜0.05）, whereas in hypertensives, FLI was not an influencing factor of LVMI. Further subgroup analysis by age revealed that FLI was the influencing factor for LVMI in the elderly（≥60 years） normotensives（P＜0.05）. Subgroup analysis based on BMI and age showed that FLI was the influencing factor of LVMI in elderly normotensives whether they were overweight or not（all P＜0.05）. Conclusion For normotensive people（especially the elderly）, FLI is the main influencing factor for LVMI.