Objective To explore the relationship between mutations of mitochondrial transfer RNA (tRNA) gene and maternal essential hypertension (EH). Methods According to the criteria of EH diagnosis and maternal inheritance discrimination, 17 patients with maternal inheritance EH (group A) and 65 patients with non-maternal inheritance EH (group B) were screened out from our hospital during January 2015 to December 2018. Thirty-three healthy individuals who took physical examination in our hospital during the same period were also subjected as control group. The whole mitochondrial DNA (mtDNA) was sequenced and compared with the modified Cambridge sequence of MitoMap. The mutation rate of mitochondrial tRNA gene and its relationship with maternal inheritance EH were analyzed in the 3 groups. SPSS statistics 19.0 was used for data analysis. Results The subject with maternal EH accounted for 20.7% (17/82) of the EH population screened. Compared with control group (0.04%), the total variation rate of mito-chondrial tRNA gene was significantly higher in group A (0.28%, P=0.024) and group B (0.12%, P=0.046), but there was no significant difference between group A and group B (P=0.076). Further analysis for group A showed that only one mitochondrial tRNA locus mutation in probands A06, A11 and A13 occurred mtDNA A5823G, mtDNA T4386C and mtDNA C15910T mutations in 3 families respectively. The incidence of EH in maternal members of 3 families was 53.8%(7/13), 87.5%(7/8) and 75.0%(9/12), respectively. The incidence of EH was high, suggesting that the mutations at these 3 loci might be closely related to maternal EH. In addition, mtDNA 5597 deletions were found in group A (4 cases, 23.5%), group B (14 cases, 21.5%) and control group (1 case, 3.0%). Compared with control group, the deletion rate of mtDNA 5597 was significantly higher in group A (P=0.002) and group B (P=0.002), but there was no significant difference between group A and group B (P=0.127). Conclusion The mutations of mtDNA A5823G, mtDNA T4386C and mtDNA C15910T are closely related to maternal inheritance EH but the deletion of mtDNA 5597 was not related to maternal EH.