Traditionally, diaphragmatic ruptures after blunt trauma have been repaired with laparotomy. We demonstrate the laparoscopic repair of an acute blunt diaphragmatic rupture in a hemodynamically stable 25 year old high-speed MVC victim. CT demonstrated acute herniation of the stomach into the chest. Laparoscopy confirmed gastric herniation through a 6-cm radial tear in the left diaphragm, extending to the left crus behind the esophagus. Esophageal mobilization was crucial to expose the extent of the tear. The diaphragm and the left crus were repaired using interrupted 2-0 ethibond sutures. The disrupted esophageal hiatus was reapproximated with interrupted 2-0 ethibond sutures over a 48 french bougie. The lesser curve of the stomach was attached to the right crus. Of note, the patient never required a chest tube and pneumothorax was not evident intra- or postoperatively. He was extubated following the procedure and discharged home on the third post-operative day. Laparoscopic repair of diaphragmatic ruptures may require more than basic laparoscopic skills. Even for large diaphragmatic lacerations, a chest tube is not mandatory.