Objective · To explore the association of fat content with left ventricular hypertrophy (LVH) in peritoneal dialysis (PD) patients. Methods · Eligible PD patients in Renji Hospital, Shanghai Jiao Tong University School of Medicine from November 2016 to June 2017 were recruited.Demographic data of patients were collected and biochemical indicators were measured. Fat content was measured by bioelectrical impedance analysis,and LVH was accessed using echocardiography. The prevalence of LVH in PD patients was compared between groups with different fat contents. Logistic regression was used to analyze the associated risk factors of LVH. Results · A total of 163 PD patients with a mean age of 55.85±13.20 years and a median PD duration of 46.0 (20.0, 73.0) months were enrolled. Of them, 98 patients (60.1%) were male, 34 patients (20.9%) had diabetes mellitus, 19 patients (11.7%) combined with cardiovascular disease and 122 patients (74.8%) were hypertensive. There were 51 patients (31.3%) with LVH, including 31 patients (37.8%) in high fat tissue index (FTI) group (n=82) and 20 patients (24.7%) in low FTI group (n=81). Logistic regression analysis indicated  that FTI (OR=1.133, 95% CI 1.003-1.280, P=0.044), overhydration (OR=1.651, 95% CI 1.257-2.169, P=0.000) and hemoglobin (OR=0.972, 95% CI 0.948-0.997, P=0.028) were independently associated with LVH in PD patients. Conclusion · LVH is common in PD patients, especially in high fat content patients. Higher fat content, higher overhydration and lower levels of hemoglobin are risk factors for LVH in PD patients.