A 10-year experience with 30 diaphragmatic injuries in 28 patients is reviewed. The left diaphragm was injured in 22 and the right in eight instances. Nine of 10 patients with penetrating trauma had diaphragmatic tears of less than 5 cm in length. Ethanol intoxication was detected in 47% of the patients involved in road accidents. Twenty percent of auto accident victims were restrained. Transabdominal repair is the procedure of choice because of the high incidence of associated trauma (79%). Right thoracotomy was required in 25% of the patients to facilitate repair of right diaphragm rupture. The mortality rate was 7%.