Apical hypertrophic cardiomyopathy is a disease with clear electrocardiographic and echocardiographic characteristics. However, poor visualization of apical endocardial border is a limiting factor to diagnose apical hypertrophic cardiomyopathy by echocardiography. We present a case report of a patient with a characteristic electrocardiogram but poor apical endocardial border delineation. A contrast-enhanced echocardiography was performed to confirm the diagnosis of apical hypertrophic cardiomyopathy. We discuss the role of echocardiographic image enhancement with contrast to diagnose apical hypertrophic cardiomyopathy.