Hypertrophic cardiomyopathy (HC) is a diverse disease with many morphologic manifestations.(1) One of the least common of these features is an aneurysm or diverticulum that develops in the apical portion of the left ventricle and is often associated with midcavity muscular narrowing and outflow obstruction.(2-6) We have encountered 3 such patients with apical left ventricular (LV) protrusions, A description of the clinical and structural features in this subgroup of patients with HC is the purpose of this communication.