Parahiatal diaphragmatic hernias are rare entities.We report a case of a primary parahiatal hernia that was repaired laparoscopically with a composite mesh.The current report is intended to depict the clinical profile, the diagnosis and treatment of this rare disease.A 73-year-old woman presented to us.CT scan showed a paraesophageal hernia with intrathoracic stomach.During the laparoscopic approach, A diagnosis of parahiatla hernia was made, which was distinct from the esophageal hiatal hernias.The hernia sac was large and the adhesion was intense.A laparoscopic mesh repair was performed with a composite mesh and Dor procedure.Parahiatal hernia has a low incidence rate, and prone to sever complications, usually can not be distinguished from esophageal hernia prior to operation.Laparoscopic repair of parahiatal hernia is feasible mini-invasive and safe.