This case presents a novel approach for repair of a traumatic thoracic and abdominal hernia. This is a 68 year old Caucasian male who presented to our clinic for evaluation of a right sided thoracic flank hernia after trauma 2015. Patient has had previous attempted repair of the right flank hernia via 18 by 10 cm mesh in April of 2016, with recurrence of hernia. Preoperative imaging obtained showed a large right lateral abdominal wall and posterolateral chest wall hernia containing small bowel loops, colon with associated hernia of right lateral and posterior segments of right lung found between the right 9th and 10th ribs. In December of 2017 patient underwent open reduction and internal fixation of ribs 9 and 10 using Synthes rib plating cage system, titanium mesh cage placed over thoracic hernia, and laparoscopic repair of remaining diaphragmatic hernia with 22 cm x 19 cm Proceed mesh intraperitoneal onlay placement. Patient post-operative course remained uneventful as chest tube was removed on post -op day number 7. A 14 Fr pigtail chest tube was placed with resolution of apical pneumothorax. Patient Incentive spirometry effort improved, with pain controlled, and had return of bowel function. Patient staples were removed and was discharged in stable condition to rehabilitation facility. Upon post-operative follow-up visit patient was found to have no recurrence of thoracic hernia and abdominal hernia and had return to activities of daily living and good inspiratory and expiratory effort.