To assess the relationships between patterns of left ventricular hypertrophy and giant negative T waves (greater than 15 mm, GNT), 24 patients with GNT were categorized in two groups: Group A consisted of 12 patients with GNP but without left ventricular hypertrophy (greater than 13 mm at the chorda level of the interventricular septum and/or left ventricular posterior wall by UCG, LVH); and group-B consisted of 12 patients with GNT and LVH. Twelve patients with LVH but no GNT compromised as group-C. Left ventriculography (LVG) was performed, and left ventricular mass (LVM) and apical hypertrophy were assessed by CT. The configurations of the end-diastolic left ventricle by LVG (RAO 30 degrees) were as follows, by group: A: spade in eight patients and papillary muscle hypertrophy (PMH) shape in four. B: spade in five, PMH in four, banana in one and oval in two. C: banana in nine and oval in three. The LVM (g/BSAm2) were as follows; A: 121.5 +/- 14.9, B: 130.5 +/- 14.8, C: 190.6 +/- 42.1 (C greater than A, B, p less than 0.001). The apex/base ratios calculated by CT were as follows; A: 1.43 +/- 0.31, B: 1.21 +/- 0.19, C: 1.09 +/- 0.20 (C greater than A, p less than 0.05). The left ventricular mass in patients with GNT was less than that of those without GNT. Giant negative T waves were most often associated with apical hypertrophy.