Minimally invasive surgery involves inserting a catheter through the femoral artery to reach the coronary arteries, visualizing the coronary arteries with a contrast agent, identifying the coronary vessels supplying the hypertrophied septal myocardium (i.e., the target vessel), and then injecting alcohol into the target vessel to occlude that vessel, causing an artificial myocardial infarction, thinning the hypertrophied myocardium, reducing obstruction, and decreasing the occurrence of symptoms. Hypertrophic obstructive cardiomyopathy (HOCM for short) is a primary hypertrophic cardiomyopathy with pathological changes mainly due to left ventricular outflow tract obstruction caused by hypertrophy of the interventricular septum, resulting in obstruction of cardiac ejection. Patients may suffer from recurrent angina pectoris, arrhythmia, syncope, and even sudden death, which pose a great threat to their lives. Currently, the main methods of treatment for this disease are drugs, surgical resection of hypertrophied septal myocardium and interventional therapy. Although medication can relieve some of the patient’s symptoms, its efficacy is limited. Open-heart surgery to remove the hypertrophied septum is effective, but traumatic and risky. Interventional therapy is a new technology developed in recent years, one of which is called percutaneous transseptal myocardial chemical ablation, a minimally invasive procedure with precise efficacy and low risk, which has been welcomed by doctors and patients. This minimally invasive procedure involves inserting a catheter through the femoral artery to reach the coronary arteries, which are visualized with a contrast medium that identifies the coronary vessels (i.e., the target vessels) that supply the hypertrophied septal myocardium. Then, a very thin wire with a soft tip is fed to the distal end of the target vessel, and a special balloon is fed along the wire to block the opening of the target vessel. The special balloon has a small hole in the center that communicates with the outside world, through which anhydrous alcohol can be injected into the target vessel to cause partial necrosis and atrophy of the hypertrophied septal myocardium, thus eliminating the obstruction, relieving the symptoms and improving the prognosis. The success rate of this procedure is more than 90%. Complications are mainly atrioventricular block, which occurs in about 2% of cases, and in severe cases, a permanent pacemaker is required. The patient can get out of bed 2 days after the operation and is discharged from the hospital after one week. After discharge, the patient can engage in general physical activities, but should avoid strenuous sports and heavy work, after 6 months the patient’s exercise endurance can be greatly improved. Due to the high technical difficulty and trauma of this procedure, it is mainly suitable for patients with frequent syncope and angina pectoris that still occurs after activity while receiving medication, and with septal hypertrophy and obstruction confirmed by cardiac ultrasound. Of course, any surgery carries some risk, and this procedure is no exception, as it can be severe and fatal. It should be reminded that since the disease is caused by a genetic mutation and we cannot change the patient’s genes, adherence to medication is required after the operation, and there is the possibility of recurrence and the need for a second or even third operation in individual patients.