Sigmoid-shaped ventricular septum (SSVS) is frequently observed in elderly patients, but association of mid-ventricular obstruction is rare. In this report, we describe 2 patients with SSVS who had mid-ventricular obstruction and intracavity pressure gradient detected by echocardiography and cine magnetic resonance imaging. Attention should be paid to SSVS because it may cause clinically significant hemodynamic derangements related to mid-ventricular obstruction.