Diaphragmatic resection necessitates complete reconstruction to avoid respiratory compromise or the displacement of abdominal contents into the chest. Often the diaphragm can be reconstructed primarily, but with larger or complete resections, reconstruction with synthetic material or autologous tissues is the most appropriate choice. To reduce the risk of denervation of the diaphragm or large intraoperative blood loss, an in-depth knowledge of the diaphragmatic innervation and blood supply are necessary when performing diaphragm resection and reconstruction.