The study of biomarkers and their related signalling pathways has allowed the development of new therapeutic strategies in a range of disorders. However, in hypertrophic cardiomyopathy (HCM), which is the most common hereditary cardiac disease, there are many potential biomarkers described, but their specificity and applicability for HCM remains an open field. The aim of the present review is to provide an overview of molecules that could give some insight into the pathophysiologic mechanisms underlying HCM, especially to those with “theranostic” - a combination of diagnostics and therapy - potential. The clinical and pre-clinical state of the art and theranostic perspectives of this topic is discussed in the present review. The better understanding of this subject would provide an algorithm, to optimize the integration of diagnosis, prognostics and therapeutics findings in HCM, leading to a tailored approach for this pathology.