  We consider Hermite-Pad\'e approximants in the framework of discrete
integrable systems defined on the lattice $\mathbb{Z}^2$. We show that the
concept of multiple orthogonality is intimately related to the Lax
representations for the entries of the nearest neighbor recurrence relations
and it thus gives rise to a discrete integrable system. We show that the
converse statement is also true. More precisely, given the discrete integrable
system in question there exists a perfect system of two functions, i.e., a
system for which the entire table of Hermite-Pad\'e approximants exists. In
addition, we give a few algorithms to find solutions of the discrete system.
