Objective：To explore the effect of lean tissue mass（LTM）/adipose tissue mass（ATM）ratio on left ventricular hypertrophy（LVH）in non -dialysis patients with chronic kidney disease（CKD）. Methods：417 non -dialysis patients with CKD were included and divided into a normal left ventricular（Non-LVH）group with 240 patients and a left ventricular hypertrophy（LVH）group with 177 patients according to the left ventricular mass index（LVMI）. Baseline data and laboratory indicators were collected，along with echocardiography and bioelectrical impedance analysis results. Baseline data and LTM/ATM ratio were compared between the two groups. Multivariate logistic regression analysis was used to determine the risk factors for LVH in non - dialysis CKD patients. The receiver operator characteristic（ROC）curve was drawn to evaluate the predictive value of LTM/ATM ratio for LVH. Results：The prevalence of hypertension，age，female ratio，and systolic blood pressure in the LVH group were significantly higher than those in the Non - LVH group，while BMI，hemoglobin，albumin，and eGFR were significantly lower than those in the Non - LVH group，all with statistical differences. The LTM，lean tissue index and LTM/ATM ratio in the LVH group were lower than those in the Non-LVH group， and there was no difference in volume load between the two groups. Multivariate logistic regression analysis showed that age，BMI， systolic blood pressure，hemoglobin，and LTM/ATM ratio - gender were all independent risk factors for LVH in non - dialysis CKD patients. The area under the ROC curve of LTM/ATM ratio - gender combined with hemoglobin in predicting LVH was 0.769.Conclusion：A low LTM/ATM ratio is a risk factor for LVH in nondialysis CKD patients，and this ratio has predictive value for the occurrence of LVH in such patients.