Hypertrophic cardiomyopathy (HCM) is an inherited disease characterized by increased myocardial thickness without cardiac, systemic, or metabolic causes to explain the observed left ventricular (LV) hypertrophy. Importantly, LV systolic dysfunction influences symptoms, heart failure, and the risk of SCD in HCM. LV global longitudinal strain (LV-GLS) is a sensitive marker for detecting subclinical LV dysfunction and improving risk stratification. Integrating LV-GLS with other imaging biomarkers, such as late gadolinium enhancement and left atrial reservoir strain, may improve risk prediction. Future research should focus on refining LV-GLS cutoffs and exploring its utility for personalized risk assessment in HCM.