Hypertrophic cardiomyopathy (HCM) is a complex and the most common inheritable cardiovascular disease. Echocardiography has numerous clinical advantages, including its availability, time and cost-efficiency, and ease of use in most patients and clinical settings. 3-dimensional echocardiography, by addressing the limitations of 2-dimensional imaging, may become the technique of choice for clinical evaluation of cardiac chambers and function in this clinical scenario. This review summarizes the role of 3D echocardiography in HCM with a focus on its diagnostic features, improving the quantification of left ventricular mass and left atrial function and the identification of the common intrinsic abnormalities of the mitral apparatus. Recent implications from 3D echocardiographic assessment and deformation analysis are also discussed including their role in the clinical diagnosis, the identification of preclinical disease in carriers of HCM mutations, and the utility in the planning and monitoring therapeutic strategies.