This article contains information about hypertrophic cardiomyopathy, about anatomic, physiologic and hemodynamic aspects of formation of obstructions in left ventricular outflow tract. Treatment algorithm in this pathology depends on stage of the disease and needs differentiated approaches, taking into account features of the disease clinical course. Using transcatheter alcohol ablation of the first septal branch of left coronary artery is one of the treatment methods in patients with hypertrophic obstructive cardiomyopathy. This method is used in the treatment of hypertrophic cardiomyopathy, depending on its stage and may be considered an alternative to the surgical treatment. The article presents immediate and long-term results in 25 patients with hypertrophic obstructive cardiomyopathy.