Objectives: To investigate the differences of hypertensive patients with lacunar infarction of different ethnic groups (Han, Kazak and Uygur in Xinjiang). Methods: We investigated 1319 patients with Hypertension during January.2012 to May. 2015 in our hospital, Among patients 700 male, 619 femal; 746 Hans, 343 Uygur, 230 Kazak. We Compared the three nationalities with general data, laboratory examination, differences in ABPP, carotid artery ultrasound and make relevant regression analysis. Results: The 1319 hypertensive patients with lacunar infarction are 256 Hans, 112 Uygur, 96 Kazak. The lacunar infarction more likely occurd in frontal area of Han, in brainstem of Uygur, in corona radiate and brain parenchyma of Kazak (P < 0.05). The carotid atheroselerosis occurs in the interal carotid artery percent from high to low in turn is Uygur, Kazakh and Han (P < 0.05). The logistic regressions shows: Age, CyC, nSBP is closely related to the Hans hypertensive patients occurrence of lacunar infarction. Age, CyC, SBP in the morning, heart rates, carotid plaques is closely related to the Uygur hypertensive patients occurrence of lacunar infarction. Age, CyC is closely related to the Kazak hypertensive patients occurrence of lacunar infarction. Conclusion: This study shows in the hypertensive patients in Xinjiang, The genetic factors may be related to the percent of lacunar infarction and carotid atheroselerosis occurd in which area are different in the three nationalities. Age, CyC is closely related to hypertensive patients occurrence of lacunar infarction in the three nationalities. Age, CyC is closely related to hypertensive patients occurrence of lacunar infarction in the three nationalities. But Han is also associated with nSBP, Uygur is also associated with SBP in the morning, heart rates and carotid plaques.