Isolated right ventricular (RV) hypertrophy is a common diagnosis at echocardiography. Mid-ventricular obstructive involvement represents however a really unusual finding. Currently available studies on right-sided hypertrophic cardiomyopathy, regardless of whether they are associated with RV outflow tract obstruction, are usually limited to single cases. Besides, there is still no agreement about the clinical relevance and management of RV hypertrophy. In the present study the authors describe the echocardiographic findings of a patient presenting with RV hypertrophy in whom a rare coexistence of both fixed RV outflow tract and intraventricular dynamic obstruction was observed. Some functional effects of verapamil treatment are also discussed.