Background and aim: The normal level of serum uric acid (SUA) is generally 6.5–7 mg/dL for males and 6–6.5 mg/dL for females. The prevalence of hypertension and complications has rapidly increased worldwide, leading to significantly increased morbidity and mortality. Serum uric acid is one of the emerging recognized laboratory markers for cardiovascular diseases (CVD) in recent years. Thus, we conducted the present study to assess whether there exists an association of SUA with CVD in hypertensive patients. Materials and methods: This case–control study was conducted in 75 hypertensive patients with 25 cases having cardiovascular disease and 50 hypertensive control attending the OPD and IPD of the Department of General Medicine, Mahatma Gandhi Medical College, Jaipur. Results: In this study, mean uric acid in CVD patient was 5.89 + 1.66 mg/dL and in controls, it is 4.31 + 1.07 mg/dL. This difference was a statistically significant (p value < 0.001) negative correlation between uric acid and ejection fraction. It shows with the increment of uric acid levels ejection fraction decreases proportionately. As the severity of cardiovascular disease increases, uric acid levels also increase. Conclusion: According to our study, it seems that UA is a real risk factor for the development of CVD. We have shown that serum uric acid levels are negatively associated with ejection fraction. Under these conditions of reduced ejection fraction, serum uric acid is an independent risk factor for CVD, respectively, in individuals with hypertension.