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Background: The aim of the present study was to investigate the effects of the left ventricular outflow gradient on tissue doppler imaging (TDI) values in patients with hypertrophic cardiomyopathy (HCM). Methods: This prospective observational study was conducted in a tertiary referral heart hospital (Tabriz, Iran) from March 2004 to March 2008. Fifty two patients (28 men and 24 women) with definite diagnoses of HCM were selected for the study. 2D, M-mode echocardiography and TDI were performed for all patients. In TDI, the velocities of myocardium was measured at lateral and septal corner of the mitral valve annulus in peak early diastolic (Ea), peak late diastolic (Aa) and peak systolic (Sa). Then, the TDI velocities were compared in patients with left ventricle outflow gradient less and more than 30 mmHg. Results: The mean age of the patients was 42.13 ± 12.22 years. All patients were in New York Heart Association functional class I or II. The mean EF was 55 ± 7%. It was found that TDI velocities are reduced in patients with HCM, compared to normal vaues and Ea in septal corners of the mitral annulus was reduced more in patients with left ventricle outflow gradient > 30 mmHg (5.3±1.6 vs 7.1±1.2, P=0.01). Conclusion: TDI findings specially peak early diastolic (Ea) mitral annular velocity are good parameters in HCM patients assessment.