Background: Diaphragmatic injury is an uncommon result of blunt and penetrating trauma. To recognize this injury, the radiologist must be familiar with the imaging manifestations of the injury. The purpose of this study was to review our experience with the radiologic management of traumatic diaphragmatic rupture (TDR) in order to identify the factors contributing to the diagnostic process. Methods: The general part of the report is based on articles found with the keywords "Diaphragm AND Rupture AND Imaging" and "Diaphragm AND Rupture AND Trauma AND CT" in Medline. In addition twelve patients with TDR admitted to our hospital between June 2004 and July 2005 have been investigated retrospectively. Results: The study identified 9 men and 3 women with ages ranging from 20 to 78 (mean 52,3). Rupture was right-sided in 6 and left-sided in 6 of the patients. The incidence of blunt and penetrating trauma was equal in this material. The diagnosis was established preoperatively in 3 patients (25 %). Alle these had left-sided injury from blunt trauma. One patient had suspect findings on chest x-ray and one had diagnostic findings on CT that was overlooked in the acute setting. These two patients had right-sided injury. All patients were treated surgically. Multiple associated injuries were observed in all the patients. The overall mortality was 58 %. Conclusions: The sensitivity of chest x-ray seems to be higher among patients with left sided rupture from blunt trauma than than those with right-sided rupture or patients with penetrating injury. Diaphragmatic rupture should be suspected in all blunt or penetrating trauma to the lower thorax and upper abdomen.