Objectives: The aim of this study was to assess gender differences in left ventricular (LV) hypertrophy among patients with arterial hypertension. Design and Methods: The study comprised 120 patients (56 men and 64 women) with 10-year history of arterial hypertension, aged 56.9 ± 10.8 years. LV hypertrophy was assessed by echocardiography criteria – left ventricular mass LVM (g), left ventricular mass index LVMI (g/m2), and left ventricular end diastolic diameter LVEDD (cm). LV geometry was identified based on LVM index and relative wall thickness (RWT). Results: Hypertensive men had significantly higher LV mass (LVMmen = 375.36 ± 73.60, LVMwomen = 332.82 ± 75.76; p = 0.002) and LV end diastolic diameter (LVEDDmen = 6.02 ± 0.47, LVEDDwomen = 5.70 ± 0.50, p < 0.0001). Based on left ventricular mass as criterion, LV hypertrophy was diagnosed in 41 (73.2%) men and 30 (46.9%) women. When left ventricular end diastolic diameter was applied, LV hypertrophy was reported in 46 (82.1%) men and 37 (57.8%) women. Left ventricular mass index was similar in both groups (LVMImen = 184.59 ± 37.02, LVMIwomen = 183.64 ± 35.96; p = 0.887). Relative wall thickness was similar in both groups (RWTmen = 0.38 ± 0.04, RWTwomen = 0.40 ± 0.05; p = 0.129). In men, the most common LV geometry pattern was eccentric LV hypertrophy [36 (64.3%)], followed by concentric hypertrophy [5 (8.9%)] and concentric LV remodelling [1 (1.8%)]. Among women, eccentric LV hypertrophy was diagnosed in 27 cases (42.2%), followed by concentric remodelling [12 (18.8%)] and concentric LV hypertrophy [3 (4.7%)]. Gender differences in LV geometry were highly statistically significant (p = 0.006). Conclusion: Left ventricular hypertrophy was more often present in hypertensive men than in women. Eccentric LV hypertrophy was the most frequent geometry pattern in all patients, but concentric remodeling was more often diagnosed in hypertensive women than in men.