This activity examines the evolving management of obstructive hypertrophic cardiomyopathy (oHCM), from persistent unmet needs to precision-based therapy with cardiac myosin inhibitors. Faculty review ongoing symptom burden and functional limitations despite guideline-directed first-line therapy with beta-blockers and analyze mechanistic, pharmacokinetic, and pharmacodynamic differences among available agents, including their effects on peak VO₂, left ventricular outflow tract gradients, and patient-reported outcomes. Through expert discussion and case-based application, the activity highlights practical considerations for treatment selection, individualized dosing and titration, safety monitoring, and treatment transitions to support evidence-based strategies that optimize hemodynamics and improve quality of life in patients with oHCM.