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Introduction Cardiomyopathies are a heterogeneous heart diseases group in terms of morphology and aetiology. Hypothesising a tropical specificity and given an absence of data in French Guiana, the primary objective of our study was to describe morphologies and aetiologies of cardiomyopathies observed at Cayenne General Hospital.Methods A cross-sectional study was conducted in Cayenne Hospital from 1 January 2009 to 1 June 2014 in the hospital database. Only patients with the definition of the European Society of Cardiology (ESC) were included, based on the first transthoracic ultrasonography found during the study period. Medical files were consulted.Results With 182 patients included, the prevalence of cardiomyopathies among heart diseases was estimated at 4.3% (95% CI 3.7% to 4.9%). Twelve patients had a familial or genetic aetiology (6.6%) and 170 a non-familial or non-genetic aetiology (93.4%). The morphological spectrum was: dilated for 114 patients (62.6%), hypertrophic for 27 (14.8%), unclassified for 1 (0.5%) and non-classifiable for 13 (7.1%). This group was constituted of patients with a systolic and/or diastolic functional impairment without morphological abnormality. The aetiological spectrum found 184 aetiologies including: 70.9% undetermined, 8.7% infectious (with 6.5% chagasic and 0.5% related with human immunodeficiency virus) and 6.0% with toxins.Conclusions Cardiomyopthies are a common and severe clinical problem. The frequency of infectious aetiologies and dilated impairment are arguments for cardiomyopathies with tropical particularities. However, the preponderance of undetermined aetiologies justifies the development of further research programmes.