Hypertrophic obstructive cardiomyopathy (HOCM) is rarely associated with significant coronary artery stenosis. Differential diagnosis may be difficult because of similar symptoms; therefore we suggest coronary arteriography in all patients above 30 years of age having HOCM and angina associated. Obviously, in case the clinical diagnosis is coronary artery occlusive disease, left ventriculography is mandatory to rule out HOCM. Four medical treatment beta-blocking agents are the drugs of choice associated, if needed, with coronary dilators, avoiding nitrates. In case surgical treatment is selected, complete correction of all lesions is indicated.