A Morgagni hernia is a rare anterior hernia of the diaphragm, accounting for 2-3% of all congenital diaphragmatic hernias. It is typically diagnosed in childhood with presenting symptoms of dyspnea. The hernia usually contains omental fat but can contain transverse colon (60%) and stomach (12%). We present our 3-port, laparoscopic repair of a Morgagni hernia in a frail 90-year-old female who presented with a gastric outlet obstruction. She had significant comorbidities including, hypertension, hyperlipidemia, congestive heart failure with moderate diastolic dysfunction, moderate aortic stenosis and atrial fibrillation. The patient's advanced age, multiple comorbidities, exercise tolerance of <4 METS and kyphosis limited her baseline respiratory status, potentially limiting her ability to tolerate intubation and general anesthesia. The patient's symptoms failed to resolve with nasogastric decompression. Intra-operatively, the patient underwent a diagnostic laparoscopy, reduction of hernia contents and primary closure of the 4 cm hernia defect using 0 Ethibond sutures in a horizontal mattress, fixed intercostally using a suture passer. Post-operatively the patient was extubated on post-operative day 1, started on diet on postoperative day 3 and subsequently discharged home on post-operative day 5. At 6-month follow-up, she has restoration of her right hemithorax with persistent closure of the hernia defect. She continues to tolerate her regular diet with improved functional capacity now able to ambulate with minimal assistance. Our repair demonstrates a durable, non-mesh option that allowed expeditious recovery and improved pulmonary function in an elderly, frail patient.