Objective: Left ventricular hypertrophy (LVH) is highly predictive of cardiovascular (CV) events in dialysis patients. The impact of different left ventricular (LV) geometric patterns on cardiovascular outcome has not been well established. The aim of this prospective observational study was to define the patterns of LVH and find out their impact on future cardiovascular events in patients on continuous ambulatory peritoneal dialysis (CAPD). Material and Methods: Patients were followed up between 1999 and 2006 for cardiovascular events. Left ventricular mass and geometric patterns were determined by echocardiography. Kaplan-Meier method and Cox regression analysis were used to evaluate the impact of LV geometric patterns on CV event free survival. Results: Sixty-five CAPD patients were enrolled in the study and were followed for 76 +/- 15 months. There were a total of 16 (14 fatal, two non-fatal) CV events. Mean event-free survival time for patients without LVH was 79 +/- 3 months (95% CI of 73 to 86 months). The mean CV event-free survival for the patients with concentric LV hypertrophy and eccentric hypertrophy was 75 +/- 3 months (95% CI of 69 to 81 months), and 76 +/- 3 months (95% CI of 69 to 82 months) respectively. Patients with eccentric [hazard ratio (HR): 20.2] and concentric (HR:18.7) LV hypertrophy had shorter time to CV event when compared to the patients without LV hypertrophy (p= 0.042). Conclusion: Left ventricular hypertrophy is a marker of poor cardiovascular prognosis irrespective of its pattern. Both eccentric and concentric LV hypertrophy are associated with shorter CV event-free survival compared to normal geometry and concentric remodeling.