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Two-dimensional and M-mode echocardiograms were obtained during the thirty-second week of gestation from 69 women classified as follows: group I, 22 normotensive primigravid women; group II, 16 primigravid women with pregnancy-induced hypertension; group III, 21 percent women with essential hypertension; and group IV, 10 normotensive nonpregnant control subjects. Systolic, diastolic, and mean arterial pressures were higher in groups II and III than in groups I and IV (p less than 0.001). Echocardiographic dimensions were significantly increased in group III compared with the other groups (p less than 0.01). No significant differences were observed among the other groups in the echocardiographic parameters or in the indices of ventricular performance studied. In echocardiographic studies, chronic hypertensive pregnant women are distinguished from patients with pregnancy-induced hypertension because the former have ventricular hypertrophy resulting from the pressure overload exerted for a long period of time. Our patients with essential hypertension experienced no changes in left ventricular performance because of the early stage of their hypertensive disease.