Paraduodenal hernias account for half of all internal hernias and result from an abnormal rotation of the midgut and failure of fixation of the left or transverse mesocolon to the posterior abdominal wall. Paraduodenal hernias are a rare cause of intestinal obstruction resulting in up to 50% mortality due to a delayed diagnosis. Here we present the case of a laparoscopic paraduodenal hernia repair. The patient is a 62-year-old female with no past medical or abdominal surgical history who presented to the ED with one day of sharp abdominal pain, nausea, and emesis. A CT scan of the abdomen and pelvis showed findings concerning for an internal hernia. The patient was taken for an emergent diagnostic laparoscopy. The abdomen was entered with an open Hasson technique and an additional four trocars were placed for the surgeon and the assistant. Paucity of the small bowel intra-abdominally and a large bulge posterior to the stomach were noted. The omentum was retracted and the the lesser sac entered, however, no small bowel was seen. Upon further inspection, small bowel was found herniating left of the midline between the left mesocolon and the posterior abdominal wall. A paraduodenal hernia was thus diagnosed. After careful reduction of the small bowel, the hernia ring was closed using a non-absorbable unidirectional stitch to prevent re-herniation. The patient's hospital course was uneventful. Subsequent outpatient follow up showed complete resolution of her prior symptoms without signs of obstruction.