Focal eventration involving the posterior segment of the
hemidiaphragm is a rare congenital anomaly. We report of a 10-
day-old infant who presented with significant respiratory
insufficiency and failure to show any responses to standard
treatment. The diagnosis of focal eventration of the diaphragm
was not anticipated until ultrasonographic examination revealed
the defect. Diaphragmatic plication resulted in complete
resolution of symptoms. A high level clinical awareness is
crucial as a relatively simple surgical procedure could avert long
term life-threatening complications.