The authors report the cure of six recent cases of strangulated or impacted diaphragmatic hernia: 3 post-traumatic, 2 hiatal, one congenital. Strangulation or simple impaction are responsible for ischemic phenomena with necrosis and intrathoracic visceral perforation. Intensive care for respiratory, cardio-vascular and metabolic complications, including gastric aspiration, has transformed the prognosis which was recently so poor in this condition. The thoracic approach is advised for the usual reasons and owing to frequent intrathoracic adhesions. It is also advised for ease of treatment of the strangulated viscus and local septic complications.