In patients undergoing operative intervention for hypertrophic cardiomyopathy (HCM), intrinsic abnormalities of the mitral valve may need to be addressed at the time of septal myectomy. Advantages of a transmitral approach to septal myectomy include a panoramic view of the septum and the exposure necessary to address concomitant mitral valve pathology. Herein, we describe our technique for transmitral septal myectomy in symptomatic patients with HCM. The transmitral approach to septal myectomy should be given consideration as the preferred approach for the surgical treatment of HCM.