A 23-year-old man visited the trauma center after being involved in a traffic accident with complaints of chest pain and right ankle pain. His initial vital signs were stable, with no abnormal laboratory findings except for elevated levels of liver enzymes. Radiologic examination revealed minimal hemothorax and right hemidiaphragm elevation as well as bimalleolar fracture in the right ankle (
Fig. 1). The presence of hump and band signs led to the suspicion of right-sided diaphragmatic injury (
Fig. 2). Owing to this suspicion and because we wanted to perform a planned operation, such as VATS, the patient was admitted to the general ward for observation. The next day, he developed dyspnea, and liver enzyme levels were further elevated. Therefore, we decided to immediately perform VATS (
Video 1). We observed bloody effusion (300 ml) and right-sided anterior diaphragmatic rupture (10-cm in length) along with superficial laceration on the exposed liver portion. Bleeding within the liver was controlled via electrocautery and use of hemostatic materials. The ruptured diaphragm was successfully repaired via VATS, and the patient was discharged on postoperative day 12 without any complications.