Background: Hypertension is a leading non-communicable disease in Nigeria. It is also the most prevalent cardiovascular disease. To reduce the burden of cardiovascular disease, management strategies are now focusing on preventive measures. Left ventricular mass and microalbuminuria have been found to be independent predictors of cardiovascular morbidity and mortality. Abnormal left ventricular geometric patterns also increase the burden of morbidity and mortality. The association between left ventricular mass and microalbuminuria has been established in some studies. The relationship between microalbuminuria and hypertension has not been widely studied in Nigeria. This study was carried out to add to the body of knowledge of hypertension in Nigeria and to provide data in proper identification, stratification and better management of patients. Methods: One hundred and fifty individuals were recruited for the study. This comprised of one hundred hypertensive cases (48 males and 52 females) and fifty controls (20males and 30 females). The basic anthropometric parameters and blood pressure were done for each individual. Echocardiography was performed according to the American Society of Echocardiologists guideline. The modified cube formula was used to calculate left ventricular mass. Left ventricular hypertrophy was defined as left ventricular mass indexed to height2.7 >51g/m2.7 . The relative wall thickness and presence or absence of echocardiographic left ventricular hypertrophy was used to determine the various left ventricular geometric patterns. Micral strip was used to determine microalbuminuria using early morning urine. Results: The mean ages of cases was 47.67 ± 13.72years and control 43.92 ± 12.90years. There was no significant difference between the mean ages of both groups. The basic anthropometric parameters were comparable in the two groups. The frequency of microalbuminuria was 48% in the cases and 8% in the controls while the frequency of left ventricular hypertrophy using LVM/ht2.7 was 32.3%. 44.4% of cases had normal left ventricular geometric pattern. 27.3%, 15.2% and 13.1% had concentric remodeling, eccentric hypertrophy and concentric hypertrophy respectively. This was significantly different from the controls where 85.7%, 10.2%, 4.1%, 0% had normal, concentric remodeling, eccentric hypertrophy and concentric hypertrophy respectively. The mean blood pressure (SBP and DBP) was significantly higher in those with LVH than in those without. The mean blood pressure (SBP and DBP) was also higher in those with microalbuminuria when compared to those without microalbuminuria. There was a trend of increasing LVM with increase in microalbuminuria but this increase was not statistically significant. The proportion of cases with microalbuminuria was higher in those with abnormal left ventricular wall geometry 68.6% than in those without (31.4%). This difference was found to be statistically significant. Conclusions: This study shows that abnormal left ventricular wall geometry was associated with presence of microalbuminuria in hypertensive patients. There was also a trend of increasing left ventricular mass with increase in microalbuminuria.