We present a patient with longstanding GERD who underwent a Nissen fundoplication and was later diagnosed with an epiphrenic diverticulum. He underwent a transhiatal laparoscopic epiphrenic diverticulectomy, takedown of the Nissen fundoplication, and left anterior hemiplication which is shown in this presentation. Tight fundoplications or similar entities such as lap bands may potentially give rise to achalasia or pseudo-achlasia, however, a literature search could not produce any case report of a pulsion diverticulum associated with a fundoplication. Epiphrenic diverticulectomy and repair of recurrent hiatal hernia can be safely managed with transhiatal minimally invasive surgery.