Clinical and laboratory data of apical hypertrophic cardiomyopathy were reviewed based on our own experience of 120 consecutive patients, emphasizing various electrocardiographic characteristics including their natural course and the diagnostic capability of nuclear magnetic resonance imaging(MRI). This peculiar disease entity was mainly detected by annual health check and characterized by giant negative T waves(-1.2(-)-4.0 mV) in the middle-aged men. Transition from normal T wave to the inversion required several years and then usually unchanged, and may disappear within several years in occasional case, in which apical aneurysm was developed. The prognosis was generally good, but atrial fibrillation caused heart failure in 4 cases. MRI was conclusive to identify the diversity of muscular hypertrophy, and it was much more diagnostic than left ventriculography, because it was capable to obtain the exact short-axis view of many sections in addition to the long-axis view. Another look including echocardiography, ultrafast computed tomography, therapy and natural history was concisely reviewed.