Left ventricular hypertrophy (LVH) increases the risk of cardiovascular morbid events in hypertension. TGF-beta1 is involved in pathologic states such as cardiac hypertrophy and cardiac fibrosis; we thus postulate that the TGF-beta1 polymorphism is related to LVH in hypertensives. Six hundred and eighty essential hypertensive patients were recruited. Biochemical variables and clinical data were obtained and the determination of LVH was performed by echocardiography. According to the presence of LVH, all subjects were divided into the LVH+ and LVH- group. DNA was obtained, and two coding region polymorphisms of the TGF-beta1 gene (+869 Leu-->Proat codon 10 and +915 ARG-->Pro at codon 25) were analyzed by the polymerase chain reaction. The product was cleaved with the restriction endonucleases. For the polymorphisms of the +869 Leu-->Pro at codon 10, there was no marked difference in the distributions of genotypes and the allele frequencies between the LVH+ and LVH- subjects. For +915 Arg-->Pro at codon 25, a significant difference in the distributions of genotypes of TGF-beta1 was observed. The left ventricular mass index (LVMI) in Arg-Pro genotype carriers was significantly higher than those in the Arg-Arg and Pro-Pro carriers. Multivariate analysis showed that the Arg-Pro genotype was an independent risk factor for LVH (OR 3.23, 95% CI [1.48-5.63, P = 0.002]). The codon 10 genotypes did not show a significant association to LVH. Our data revealed a genetic association of TGF-beta1+915 Arg-->Pro at codon 25 polymorphism with LVH in a Chinese hypertensive population.