: Hypertension is the commonest non communicable disease in Nigeria, and heart failure is one of its common complications. Heart failure is associated with high mortality. A stage of asymptomatic left ventricular systolic dysfunction (LVSD) is known to exist in hypertensive patients well before overt heart failure. Treatment at this stage is known to prevent, or at least delay the onset of overt heart failure. Early recognition of such patients therefore becomes imperative. One of the safest methods of assessing left ventricular systolic function is echocardiography. Some authors have reported significant association between echocardiographic evidence of LVSD and electrocardiographic (ECG) evidence of left ventricular strain pattern. There are reports suggesting that this ECG pattern may be an early indicator of the presence of LVSD in hypertensive patients. Aim: This study seeks to determine if left ventricular systolic dysfunction (LVSD) exists in Nigerian hypertensive patients who are not symptomatic for heart failure. It also aims to find the relationship between resting ECG evidence of left ventricular (LV) strain pattern, and echocardiographic evidence of LVSD in Nigerian hypertensive patients who are not symptomatic of heart failure. Method: Hypertensive patients attending the cardiology clinic of Lagos University Teaching Hospital (LUTH) were classified into 3 groups based on their ECG diagnosis. Group 1 had ECG evidence of left ventricular hypertrophy and strain pattern. Group 2 had ECG evidence of left ventricular hypertrophy (LVH) by voltage criteria only, Group 3 had normal ECG. Healthy non hypertensive members of staff of Lagos University Teaching Hospital/ College of Medicine University of Lagos (LUTH/CMUL) with normal electrocardiograms were used as controls. For all the subjects, clinical assessment was done, followed by echocardiographic assessment of their left ventricular dimensions and systolic function. Comparison was done across the groups using ANOVA, post hoc analysis, or chi square as appropriate. Multiple regression analysis was used to assess the predictive ability of ECG evidence of LV strain pattern for echocardiographic evidence of LVSD. Result: Left ventricular wall dimensions, left ventricular cavity size and volumes, and left ventricular mass (LVM) were significantly higher in subjects with ECG evidence of LVH and strain pattern than in those without this ECG pattern. Subjects with ECG evidence of LVH and strain had poorer indices of left ventricular systolic function than those without this ECG pattern. Subjects with ECG evidence of LVH and strain, as well as those with LVSD had poorer blood pressure control. The prevalence of LVSD was higher in the hypertensive groups than in controls. Conclusion: LVSD exists in Nigerian hypertensive patients who are not symptomatic for heart failure. ECG evidence of LV strain pattern is closely correlated with echocardiographic evidence of LVSD in Nigerian hypertensive patients. Hypertensive patients with ECG evidence of LVH and strain have a more severe LVH and poorer left ventricular systolic function than those with LVH diagnosed by voltage criteria only, and those with normal ECG.