Backgrounds Left ventricular (LV) hypertrophy is an independent risk factor for cardiovascular and all-cause mortality and morbidity. Epicardial adipose tissue (EAT), an index of cardiac visceral adiposity, is presumed to play a potential role in the development of cardiac morphological changes both functionally and mechanically because of its anatomical contiguity to coronary arteries or myocardium without intervening structures. Few data are available concerning the relation between EAT and LV geometry. The objective of this study was to investigate the relation of echocardiographic EAT to LV geometry. Methods We enrolled 622 consecutive subjects (321 males, 59 짹 11 years old. Echocardiographic EAT thickness was measured on the free wall of the right ventricle at the end of diastole. Echocardiographic LV septal thickness, LV posterior wall thickness, LV dimension, LV mass, LV mass index and left atrial (LA) dimension were analyzed. Results The mean of EAT thickness was 3.1 짹 2.4 mm. Univariate analysis showed that EAT thickness was correlated with age, BMI, LVM, LMMI and LA diameter. Age-adjusted Pearson correlation analysis showed that there was no significant relation between EAT and any cardiac parameters which reflects LV geometry. Only in non-obese group (Body mass index (BMI) < 25 kg/m짼, n = 310), there was weak correlation between EAT and LV mass and LV mass index (r = 0.21, p < 0.001; r = 0.161, p = 0.005, respectively). Conclusion In present study, the EAT thickness was not correlated with LV geometry. Only in non-obese patients with BMI less than 25 kg/m짼, there was weak correlation between EAT thickness and LV geometry. EAT might have little role in the cardiac geometric changes.