OBJECTIVE. Contrast-enhanced MR imaging has great clinical value as a means of characterizing myocardial tissue in patients with ischemic heart disease. The purpose of our study was to evaluate use of this technique in the assessment of patients with hypertrophic cardiomyopathy. CONCLUSION. On late-enhancement MR imaging, the various types or patterns of enhancement found in patients with hypertrophic cardiomyopathy are related to differences in morphology and regional function. Enhancement in hypertrophied areas likely reflects the presence of abundant connective tissue, loci of myocardial necrosis, or a combination of both.