Objective To investigate the clinical value of multiple-slice spiral CT (MSCT) in identifying apical hypertrophic cardiomyopathy (AHCM) with giant negative T wave.Methods Sixteen patients with AHCM and giant negative T wave (AHCM group) underwent MSCT,electrocardiogram,echocardiography,coronary angiography and left ventriculography.Thirty patients without myocardial hypertrophy were enrolled as control group.Measurement results of two groups were compared.Results MSCT confirmed all patients with AHCM,but echocardiography missed 10 patients.In the end of diastole phase,left ventricular apical thickness (LVA) was (21.3 ± 3.6) mm and LVA/left ventricular posterior wall thickness (LVPW) was 2.2 ± 0.4 in AHCM group,which was (8.5 ± 1.6) mm and 0.9 ± 0.2 in control group.The level of LVA and LVA/LVPW in AHCM group were significantly higher than those in control group (P ＜0.01).Conclusion MSCT is a accurately diagnostic modality for AHCM with giant negative T wave,and the cardiac anatomy,function and coronary artery are also assessed simultaneously.