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Primary aldosteronism (PA) is the most frequent cause of secondary hypertension, and is associated with myocardial fibrosis. We recently found aldosterone induced galectin-3 secretion. The aim of this study is to investigate the association between myocardial fibrosis and plasma galectin-3 levels in PA patients.We prospectively analyzed 11 patients with aldosterone producing adenoma (APA) that received adrenalectomy from December 2006 to October 2008, and 17 patients with essential hypertension (EH) were enrolled as the control group. Plasma galectin-3 determination and echocardiography including ultrasonic tissue characterization by cyclic variation of integrated backscatter (CVIBS) were performed in both groups and one year after operation in the APA group.APA patients had significantly higher diastolic blood pressure, higher plasma aldosterone concentration (PAC), higher aldosterone-renin ratio (ARR), lower serum potassium levels, and lower plasma renin activity (PRA) than patients with EH. In echocardiography, APA patients had significantly a higher left ventricular mass index and lower CVIBS (7.3 ± 2.0 vs. 9.2 ± 1.7 dB, p = 0.015). Besides, APA patients also had higher plasma galectin-3 levels (2.1 ± 0.9 vs. 1.1 ± 0.6 ng/ml, p = 0.005) than EH patients. CVIBS is correlated to plasma galectin-3 levels. One year after adrenalectomy, CVIBS increased significantly ((7.3 ± 2.0 to 9.2 ± 2.4 dB, p = 0.032), and plasma galectin-3 levels decreased (2.1 ± 0.9 to 1.2 ± 0.6, p = 0.032) in APA patients.APA patients had increased myocardial fibrosis which was associated with increased plasma galectin-3 levels. Both increased myocardial fibrosis and plasma galectin-3 levels recovered at least partially after adrenalectomy.