Apical aneurysm in apical hypertrophic cardiomyopathy (HCM) is a very rare condition in clinical practice. Some studies have reported abnormal uptake of 18F-FDG and 18F-FAPI in HCM, respectively. We presented a case of FAPI and FDG imaging in a patient with apical aneurysm in apical HCM, and further analyzed the discrepancy of spatial distribution pattern of these 2 radiotracers.