The relationship between electrocardiographic-left ventricular hypertrophy (ECG-LVH) and stroke has been well established in the Western population with limited information in the Chinese population. This study evaluated the association between ECG-LVH and stroke outcome. A total of 19,815 (95.7%) subjects from the China Stroke Primary Prevention Trial (CSPPT) with baseline ECG were included. ECG-LVH by sex-unspecific Sokolow-Lyon criteria was detected in 1599 participants (8.1%) at baseline. After a mean follow-up of 4.5 years, 605 (3.1%) subjects were detected with new-onset stroke over the total population, baseline ECG-LVH was present in 72 (4.5%) of them during follow-up. After adjusting for various cofounders, ECG-LVH remained as an independent risk factor for stroke events in the total population (HR = 1.43; 95% CI, 1.10-1.84; P = 0.007) and male population (HR = 1.47; 95% CI, 1.07-2.03; P = 0.019). Subgroup analysis showed that baseline ECG-LVH was a risk factor for stroke in individuals younger than 65 years of age(HR = 1.80, 95% CI, 1.31-2.47 vs. HR = 1.02, 95% CI, 0.66-1.59, P value for interaction = 0.047). In summary, LVH diagnosed by ECG is associated with an excess risk for stroke in Chinese hypertensive population, especially in the age group of younger than 65 years.