Genetic variants of uncertain significance (VUS) in sarcomere genes demonstrate intermediate risk profiles between clearly pathogenic mutations and normal genetics in hypertrophic cardiomyopathy patients. Among 438 HCM patients, those with sarcomere VUS (36.3% of cohort) showed clinical characteristics and outcomes positioned between patients with pathogenic variants (39.0%) and those with no sarcomere mutations. The analysis revealed a stepwise increase in cardiovascular risk from genotype-negative patients through VUS carriers to those with pathogenic variants, with VUS patients showing a hazard ratio of 2.05 for adverse cardiac events. This challenges current clinical guidelines that classify VUS as non-actionable, potentially leaving patients with meaningful genetic risk without appropriate monitoring or intervention. The research landscape has long struggled with the clinical interpretation of genetic variants that don't clearly fit pathogenic or benign categories. These findings suggest VUS may represent a spectrum of sarcomere dysfunction rather than clinically neutral variants. For adults with HCM, this could transform genetic counseling and risk stratification approaches. However, as an unreviewed preprint with observational design limitations, these results require validation before changing clinical practice. The work represents an important step toward more nuanced genetic risk assessment in cardiac disease.