Background: The aim of this study was to describe the phenotypic spectrum and clinical characteristics of apical hypertrophic cardiomyopathy (ApHCM) in Korean. Methods: For the 200 consecutive patients (58.9짹11.2 years;156 men) with ApHCM, patterns of left ventricular hypertrophy by measuring end-diastolic wall thickness of all 16 segments, echo-Doppler parameters, ECG findings, clinical findings and cardiovascular comorbidity were analyzed. Results : ApHCM was classified into 3 types according to patterns of hypertrophy. Focal type (n=84) was defined as hypertrophy confined to 2 or less apical segments, diffuse (n=74) as more than 2 apical segments and mixed (n=42) as apical hypertrophy combined with asymmetrical septal hypertrophy but maximal thickness in the apical segment. Lateral apical segment was the most predominant site of maximal hypertrophy. (122 patients, 61%, mean thickness:17.8 mm). Incidence of atrial fibrillation (AF) and left atrial volume index (LAVi) were significantly different among subtypes. The degree of maximal negative T wave (maxNT) (r=0.205,p=0.006) and sum of precordial (V3-6) negative T waves (sumNT) (r=0.245,p=0.001) significantly correlated with maximal thickness of apex. Conclusions: ApHCM contains several spectrums of morphologic phenotype and this subtyping has value on determining the clinical characteristics.