The diaphragm is a large, fibromuscular, thoracoabdominal structure that separates the thoracic and peritoneal cavities. It is a dynamic, mobile organ and serves as the primary muscle driving respiration. Injury to the diaphragm is uncommon in the traumatically injured patient and found more commonly in penetrating than blunt trauma. In penetrating thoracoabdominal injuries between the nipples and the umbilicus anteriorly and between the tips of the scapulae and the lumbar spine posteriorly, diaphragm injury must be considered and evaluated for when in the operating theater. In blunt trauma, diaphragm rupture should be considered a marker for significant traumatic burden. The diagnosis requires a high index of suspicion, given the relatively low sensitivity of available imaging modalities to evaluate for subtle findings, to avoid future morbidity, which is very high in the setting of a delayed presentation of a missed diaphragm injury. There is limited role for nonoperative management of injury to the diaphragm, isolated primarily to right upper quadrant stab wounds due to the bolstering effect of the liver. Most will require operative repair.