We present a video of a laparoscopic repair of a large Type III hiatal hernia (10cm) in an 80 year-old female patient with chronic GERD. On presentation her main symptoms were heartburn and regurgitation but no dysphagia. Preoperative endoscopy showed a large hiatal hernia (6cm) and a video-esophagram showed normal esophageal motility confirming the large hiatal hernia. The patient was consented for a laparoscopic hiatal hernia repair with LINX (magnetic sphincter augmentation device) placement (Torax Medical, Johnson&Johnson). Intraoperatively a larger-than-expected hiatal hernia (10cm) was found. The technical aspect of identification of the hiatal hernia sac, correct dissection and removal of the anterior sac is explained. Further, mediastinal dissection to achieve 2-3cm of abdominal esophageal length is shown. The posterior cruroplasty is augmented with a Vicryl mesh and fixation is done with fibrin glue. The vagal nerve is excluded to prevent slippage and the distal esophagus is sized with a sizing tool for the correct LINX device placement. The patient had no post-operative complications. After the normal temporary dysphagia with the LINX device, the patient was free from dysphagia and without reflux symptoms at 3-month follow up after surgery.