Objective · To evaluate the surgical outcome of RPR composite technique for complex hypertrophic obstructive cardiomyopathy (HOCM). Methods · From June 2009 to December 2015, 9 complex HOCM patients received RPR procedure. There were 6 males and 3 females with age from 22 to 63 years old and the average age of (43±19) years old. Transthorax echocardiography (TTE) showed systolic anterior motion (SAM) and at least moderate mitral valve regurgitation (MR) in all patients before operations. Transesophageal echocardiography (TEE) was used to evaluate the results of procedures during operation. All the patients had been followed up since one week after operation and examined by TTE. Results · All the patients were discharged without complications. Intraoperative TEE indicated that left ventricular outflow tract pressure gradient (LVOTPG) significantly decreased from (92±14) mmHg before operation to (9±3) mmHg after operation (P<0.01). SAM in all the patients disappeared. One week after operation, TTE demonstrated remarkable reduction in the thickness of ventricular septum, LVOTPG and MR than those before operation (P<0.01). Mean follow-up was 26 months. All the patients became asymptomatic. LVOTPG remained low and MR remained mild. There were no deaths, reoperations, or any other adverse consequences. Conclusion · RPR technique is an effective surgical method to relieve LVOTO and MR of complex HOCM to lead a better life.