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Hypertrophic cardiomyopathy is a widespread condition that is often neglected and undiagnosed. Although there are still large gaps in our knowledge of the basic disease mechanisms, population studies have shown us that patients can have normal life expectancy but often develop disease-related complications. In this Viewpoint, Franco Cecchi, Magdi Yacoub and Iacopo Olivotto highlight the disease's screening and treatment, and some of the exciting new knowledge in the field.