Background and Objectives: Until now, apical hypertrophic cardiomyopathy (HCM) has been considered to have a benign prognosis in terms of cardiovascular mortality. The prevalence of sudden cardiac arrest and the current status of implantable cardioverter-defibrillator (ICD) implantations in patients with apical HCM remain to be elucidated. Methods: Between July 2001 and May 2021, 96 HCM patients who had undergone ICD implantations from 3 tertiary hospitals were reviewed. We evaluated the prevalence of apical HCM and the indication for an ICD implantation. Results: Fifteen patients (15.6%) had apical HCM and 81 (84.4%) the non-apical type including septal (n = 56) and diffuse (n = 25) types, respectively. Sixty-four patients (66.7%) received ICD implantations for primary prevention and 32 (33.3%) for secondary prevention.Among those with apical HCM, 7 patients (46.7%) presented with an aborted sudden cardiac death or documented ventricular fibrillation, therefore, they received ICD implantations for secondary prevention. The proportion of secondary prevention ICD implantations did not significantly differ between apical and non-apical HCM subtypes (46.7% [7/15] vs. 30.9% [25/81], P = 0.233). Conclusions The proportion of secondary prevention ICD implantations did not differ significantly by HCM subtype. ICD implantations should be considered for high-risk patients with apical HCM.