In general, a slightly enlarged left ventricle is a description of a cardiac imaging finding that the internal diameter of the left ventricle of the heart slightly exceeds the normal range of values. Clinically, the causes of a slightly enlarged left ventricle can be categorized as physiologic or pathologic. Physiologic enlargement may be due to cardiac transposition resulting in a large display on imaging, but in reality there is no substantial enlargement of the left ventricle, and therefore is the heart is normal. The causes of pathologic enlargement are relatively complex and require comprehensive judgment by the clinician in conjunction with other tests. Common causes include hypertensive heart disease and chronic heart failure. For those with enlarged left ventricle, further examination by clinician is needed to find out the cause, and if there is primary disease, timely treatment is needed.