Hypertension is an important contributor to different left ventricular (LV) geometric patterns with resultant myocardial dysfunction. Strain rate image (SRI) has been suggested as a useful tool for the evaluation of myocardial function. The aim of this study was to assess whether SRI correlates with LV geometric patterns in hypertensive subjects. Fifty-one hypertensive subjects and 21 healthy controls were enrolled and examined with conventional echocardiography including LV mass index (LVMI). Moreover, tissue Doppler imaging (TDI) and strain or SRI were obtained in all subjects. The hypertensives were subanalyzed according to geometric patterns. The hypertensive subjects were more likely to have enlarged left atrial dimensions, prolonged decelerating time and isovolumic relaxation time, and showed a lower TDI of early diastolic mitral annulus and SRI of early diastolic component (SR-e). Among hypertensive subjects, there was a significant trend toward a lower value of SR-e in those with hypertrophy and SR-e was the lowest in the concentric hypertrophy than other geometric patterns. In addition, SR-e was associated most strongly with LVMI of LV other than echoparameters. The hypertrophic hypertensive subjects showed altered systolic and/or diastolic function. Moreover, SR-e appeared to be correlated most with geometric patterns according to LVMI.