Background: Hypertension is a major cause of morbidity and mortality and affects an estimated 1.4 billion people worldwide. Long term consequences of hypertension can include ischemic heart disease, stroke, and end stage renal disease .Various ECG findings in hypertension include left ventricular hypertrophy changes, increased P wave amplitude, and changes in the ST-T segment. Left ventricular hypertrophy can be seen as QRS voltage which is increased in v5 v6 leads – left ventricle leads. Also it is calculated by using sokolow lyon criteria which is adding the amplitude of S wave in v1 or v2 and R wave in V5 or v6 (>35 mm-LVH) and Cornell criteria which shows S wave in avl and R wave in v3. A sum exceeding a certain threshold (e.g., 20 mm in women, 28 mm in men) suggests LVH.P wave amplitude is also seen for hypertensive patients in lead 2 and avl which indicate right atrial enlargement which also indicate pulmonary hypertension. ST depression and T wave inversion, Prolonged QRS duration Prolonged QT interval also can occur. Hence ECG is a pivotal investigation as >5 years of hypertension causes the left ventricular hypertrophy changes in ECG which is used to give an idea for cardiovascular event risk, STUDY METHODOLOY AND AIM: This is a retrospective study done in our institution from March2025-Feb 2026 of random selection of 100 patients after obtaining ethical clearance and informed consent from all patients who had hypertension and was on medications. In our study we used the most common method of seeing LVH in ECG by Sokolow lyon criteria The aim of the study is to correlate structural abnormalities of heart (LVH) RESULTS - LVH criteria was found predominantly in men than women which was in line with national and international studies. With duration of hypertension through noninvasive test (ECG) associated with risk factors. Males were most affected with greater than 5 years of hypertension (-49) who were positive for criteria and females (35) had greater than 5 years duration of hypertension with positive criteria. It was also found that 10 males {17%} and 6 females {15%} had positive LVH criteria in ECG even with less than 5 years duration of hypertension which was significantly important About 24 males >60 years and 16 females>60 years were having associated risk factors. It was also found 22 males and 22 females<60 years also had associated risk factors. CONCLUSION - Our study has made ECG (noninvasive) test, a mandatory test for patients with hypertension as a tool for structural assessment of the heart so that early diagnosis and management of hypertension and prevention of mortality due to CAD can be made