Introduction: Previous studies have suggested that Roma ethnic community suffers from severe cardiovascular (CV) disease at an earlier age. Asymptomatic target organ damage (AOD) is an intermediate step in the development of CV disease and is an important marker of overall CV risk. Therefore, we aimed at assessing the AOD damage in the Roma hypertensive (HTN) population. Methods: 806 adult subjects (age range 18 – 83 years) from the Roma urban community of Bucharest regardless of medical history were included in the study between 2012 and 2013. For each subject, we recorded demographic and anthropometric data and AOD was assessed according to the current guidelines – LVH (left ventricular hypertrophy) was defined on echocardiographic studies using LV mass index calculated with the Devereaux formula, peripheral arterial disease (PAD) based on the ankle-brachial index (ABI) < 0.9 in either leg, arterial stiffness based on pulse wave velocity (PWV) over 10 m/s, microalbuminuria on dipstick and eGFR was estimated using CKD-EPI study equation and chronic kidney disease stage > 3 was considered at eGFR < 60 ml/min/1.73 m2 . Results: In this urban Roma population, the prevalence of HTN was 33.6% (271 pts). The average age of the HTN population was 55.84 ± 10.87 years and 63.4% were women. From the HTN population, 46.4 % had LVH, 52.77% had PAD and 73.0% had arterial stiffness. In 53.1% of pts, the pulse pressure was > 60 mm Hg. Subclinical renal involvement was present, with 18.45% pts having microalbuminuria, and 6.27% being already in a stage III or higher class chronic kidney disease. There were no significant differences between male and females except for the higher prevalence of microalbuminuria in women. Conclusions: In the Roma population, women are more affected by hypertension. The burden of TOD is very high in this population and it starts at an early age. Both sexes seem to be affected equally except for microalbuminuria, which is more prominent in women.