Hypertrophic cardiomyopathy (HCM) is an inherited disease with a highly variable clinical course. Most patients are asymptomatic or mildly symptomatic resulting in a benign prognosis. However, some patients may present with severe symptom, such as dyspnea, chest pain, and syncope associated with sudden cardiac death and heart failure. Based on the variable presentation, several therapeutic strategies have been recognized. These include pharmacotherapy, septal reduction therapy including myectomy and alcohol septal ablation, primary or secondary prevention of fatal arrhythmia using an implantable cardioverter defibrillator, catheter ablation for atrial fibrillation, and cardiac transplantation for end-stage heart failure. Almost all such treatment strategies are based on experience in the clinical setting or are observational study-based. This symposium will be a platform to discuss couple of topics regarding the contemporary management and treatment of HCM with specialists in the US and Japan.