Hypertrophic cardiomyopathy (HCM) is characterized by heterogeneous clinical expression. Cardiac transplantation continues to be the gold standard for the treatment of end-stage cardiac diseases refractory to medical therapy. We presented a 27-year-old female patient with HCM who underwent successful cardiac resynchronization therapy after cardiac transplantation. Our patient had an indication for standard pacing. However, previous reports have shown that right ventricular apical pacing might lead to adverse clinical outcomes in patients with heart failure. We have discussed cardiac resynchronization therapy after heart transplantation in patients with standard pacing indications.