Traumatic diaphragmatic hernia encompasses a spectrum of disease ranging from acute to chronic. Chronic traumatic diaphragmatic hernia is uncommon and associated with significant morbidity and mortality. Multiplanar CT with coronal, sagittal, and axial reconstructions is most effective in making this diagnosis. Once diagnosed, repair should be undertaken. Open transthoracic repair is preferred. Basic hernia repair principles apply including the construction of a tension-free repair, which may necessitate the use of prosthetics.