Objective: To investigate the effect of hypertension on corneal endothelial cells. Methods: The automatic corneal endothelial cells analytical application were used to detect the corneal thickness and endothelial cell morphology with 296 cases (348 eyes). Patients with stages I and II hypertension were enrolled in the Group A while those with stages III and IV hypertension in the Group B. Of a total of 148 patients with hypertension (173 eyes), 87 cases(104 eyes) were enrolled in the Group A while 61 cases(69 eyes) in the Group B. Among all the subjects, there were no statistical differences in gender, age, and the exclusion of other systemic disease history. Statistical analysis was made on the corneal endothelial cells into the average density, percentage of hexagonal cells, coefficient of variation and central corneal thickness. Results: Compared with normal controls, both coefficient of variation and central corneal thickness increased while percentage of hexagonal cells and central corneal endothelial cell densities decreased in patients with hypertension, with a significant difference (P<0.05 or P<0.01). Meanwhile, for hypertension, there were significant differences in four indicators between Groups A and B (P<0.05 or P<0.01).Conclusion: There are abnormal morphology of corneal endothelial cells in primary hypertension patients, which are aggravated with the severity of disease. So when the ophthalmologist conduct the intraocular operation with hypertension patients, they should pay special attention to the protection of the cornea endothelial to prevent corneal endothelial decompensation.