Deep sternal wound infections (DSWI) occur after 1-3% of sternotomies, but are reported to be associated with mortality of up to 50%. Although antibiotic therapy, surgical drainage of abscess, and debridement of necrotic tissue are essential components in the management of DSWI, reconstruction of the sternal defect can be difficult due to the need for soft tissue coverage of the exposed right ventricle and sternal defect. Soft tissue reconstruction options include pedicled muscle flaps (pectoralis major, rectus abdominis, or latissimus dorsi) or omental flap. Here, we present an unusual case of a late presentation of severe DSWI after open heart surgery that was managed with a multi-disciplinary approach involving the thoracic, plastic, and colorectal surgery teams. A 66-year-old male with a history of coronary artery bypass 13 years ago developed severe DSWI associated with skin, subcutaneous tissue, and sternal necrosis. He underwent removal of his sternal wires and abscess drainage, followed by serial debridement of his sternal wound and negative pressure wound therapy. Once the acute infection was controlled, the sternal defect was reconstructed with a laparoscopically harvested pedicled omental flap and pectoralis advancement flap. Laparoscopic omental flap is a valuable tool in the management of complex DSWI, because it provides soft tissue coverage over large sternal defects that cannot be covered with pectoralis flaps alone. It also contains immunogenic potential that makes it ideal in severe infection. In this case, it was effective in severe DSWI with late presentation. Lastly, laparoscopic omental flap is minimally invasive and technically feasible.