Diaphragm rupture is an infrequently encountered but well-documented injury in the multiply injured patient. Only a few cases in which minimally invasive techniques were used for repair have been reported thus far. Herein we describe the repair of a diaphragm rupture in a 36-year-old man who was injured in a motor vehicle accident. In a 10-year review of the literature, we were able to locate seven journal articles reporting 10 patients. We conclude that in appropriate stable patients with diaphragm rupture, minimally invasive techniques offer a reasonable alternative to open laparotomy or thoracotomy.