Objective. Our aim was to investigate retinal nerve fi ber layer (RNFL) thickness in hypertensive patients using spectraldomain optical coherence tomography (SD-OCT) and to evaluate the relationship between RNFL thickness and carotid intima media thickness (CIMT). Methods. This study included 59 patients with hypertension (HT) (53.6 +/- 10.7 years) and 54 age-matched healthy controls (51.0 +/- 8.1 years). We evaluated anthropometric and metabolic parameters as well as RNFL and CIMT measurements in patients with hypertension and controls. Results. The average RNFL thickness was 86.60 +/- 10.86 mu m in hypertensive patients and 93.63 +/- 7.30 mu m in healthy controls (p < 0.001). Selective thinning of the RNFL was found in the superior and inferior quadrants. Mean CIMT values were higher in patients with HT (0.80 +/- 0.15 mm) than the healthy subjects (0.71 +/- 0.1 mm) (p < 0.001). The average, inferior and nasal RNFL thickness were negatively associated with diastolic blood pressure respectively (r= 0.112, r= 0.210, r= 0.225). There was an inverse correlation between RNFL thickness in the average and superior retinal quadrant and CIMT (r- =0.201, r= -0.185). There were no correlations between RNFL thickness and age, body mass index, fasting plasma glucose, lipid parameters, high-sensitive C-reactive protein and microalbuminuria. Conclusion. RNFL thickness is reduced in hypertensive patients and may be associated with atherosclerosis.