: Hypertension is still the most important risk factor for cardiovascular events. The number of hypertension in young adults is increasing. A deep insight into the clinical profile will help in devising a preventive strategy, in order to alleviate the morbidity and mortality of cardiovascular disease. However, the data about hypertensive heart disease in the young (<45 years) is limited. A cross sectional study was performed. The hypertensive heart disease was diagnosed by echocardiography. A total 130 young hypertensive heart disease cases were identified from 2016-2018. Hypertensive heart disease was determined using European Society of Cardiology/European Society of Hypertension 2018 guideline and diastolic dysfunction was determined using American Society of Echocardiography 2016 guideline. The mean age of subjects was 39.35 (±4.6) years, male patient was 67 (51.5%). Clinical presentation of the patient was hypertensive heart disease (46.99%), hypertensive heart disease with coronary artery disease (43.1%), and hypertensive heart disease with stroke (10%). Mean ejection fraction (EF) of this study was 55.86 (±15.2) %, the number of normal EF was 63.1%, preserved EF 3.1%, mid-range EF 13.1%, reduced EF 20.8%. The mean left ventricular mass was 246.92 (±90.5) gram, left ventricular mass index was 144.77 (±50.8) gram/m2. Left ventricular hyperthrophy was classified as concentric remodelling 12.3%, eccentric hyperthrophy 27.7%, and concentric hyperthropy 60%. Diastolic function was assessed, normal 10%, grade I 52.3%, grade II 18.5%, grade III 8.5%, and the rest 10.8% cannot be measured. There were a significant number of young hypertensive adults with various echocardiographic abnormalities. Prevention of hypertension should begin earlier.