Objective: To explore the effect of lean tissue mass/adipose tissue mass (LTM/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 normal left ventricular (Non-LVH) group with 240 patients and left ventricular hypertrophy (LVH) group with 177 patients according to left ventricular mass index (LVMI). Baseline data, laboratory indicators and other parameters were collected. Echocardiography and bioelectrical impedance analysis results were collected at the same time. Compare the baseline data and LTM/ATM ratio between the two groups. Multivariate logistic regression was used to analyze the risk factors for LVH in CKD non-dialysis patients. The receiver operator characteristic (ROC) curve of subjects was used 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. BMI, hemoglobin, albumin, and eGFR were significantly lower than those in the Non-LVH group, and there were 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, LTM/ATM ratio-gender were all independent risk factors for LVH in CKD non-dialysis patients. The area under the ROC curve of LTM/ATM ratio-gender combined with hemoglobin in predicting LVH was 0.769. Conclusion: Low LTM/ATM ratio was risk factor for LVH in nondialysis patients with CKD. LTM/ATM ratio could serve as a predictor of LVH in such patients.