Background: Hypertension is a serious worldwide health concern, significantly contributing to cardiac complications such as myocardial ischemia and heart failure. Chest discomfort, in hypertensive patients, can be a sign of serious illnesses such as myocardial infarction or unstable angina. Echocardiography is a non-invasive imaging that is essential for assessing the structure and function of the heart. It can identify cardiac disorders like diastolic dysfunction and left ventricular hypertrophy (LVH), which are more prevalent in hypertensive patients. As such, an echocardiographic examination can improve cardiac diagnosis and offer insightful information about cardiac health. Aim: The aim of this study was to investigate echocardiographic findings of hypertensive patients who presented with chest pain at the University Teaching Adult Hospital (UTH-Adult Hospital). Methods: This study utilised a quantitative cross sectional study design. Purposeful sampling was used to select a total of 110 participants who were examined using echocardiography. Data was collected from July to September, 2025. Results: The majority of the research participants were females (80; 72.73%) and had abnormal echocardiography findings (95; 86.36%). The most predominate echocardiography finding in this study was diastolic dysfunction, grade 1 (89; 80.91%). This study also found that there were no significant associations between echocardiographic parameters and the clinical manifestation of chest pain. (RVOT, p=0.701; LVd, p=0.878; LA, p=0.728; F/S, p=0.740; EF, p=0.734; IVSd, p=0.352: LVPWd, p=0.688; AoR, p=0.442; Diastolic function, p=0.518). Conclusion: This study showed that most patients maintained sufficient left ventricular performance despite some functional alterations. This could be attributed to early hypertensive stage. It found no significant relationship between echocardiography parameters and the clinical presentation of chest pain. This suggests that chest pain, may be multi