Hypertrophic cardiomyopathy is an inherited muscle disorder disease. Sudden death is the most dreaded complication, risk stratification is of critical importance and patients with high risk should receive an implantable cardioverter defibrillator (ICD). We report the case of 26 years old man affected by a severe form of hypertrophic cardiomyopathy. Our patient falls into a high risk category because of his young age, massive left ventricular hypertrophy and family history of premature death due to hypertrophic cardiomyopathy. Considering his risk of dying sufficiently high, we proceed to percutaneous ICD under local anesthesia. Evolution was favorable after 3 months follow up.