Hypertrophic Cardiomyopathy is a myocardial condition that may result in severe left ventricular outflow obstruction which may be symptomatic. Standard treatment strategies include medical therapy using beta blockers and Calcium Channel blockers, avoidance of dehydration and positive inotropes. However, when medical therapy fails with severe symptoms related to left ventricular outflow obstruction, left ventricular septal myectomy has been proposed and used. However, this involves major surgery and major mortality and morbidity. An alternative treatment strategy is to perform "medical myectomy" with the instillation of absolute ethanol in the septal arteries using a catheter based approach. This method is being used increasingly frequently with excellent safety with the major adverse event being complete heart block which may necessitate placement of a pacemaker which many of these patients may possess anyway.