DISCUSSION: Intercostal lung herniation is seen in patients with a history of chest wall trauma, thoracotomy, chronic lung disease, or situations requiring repeatedly Valsalva. Lung herniation is classified according to its location and the mechanism of occurrence. A plain chest film on Valsalva can show lung beyond the rib sign or lucent lung sign. CT imaging is used to visualize the herniation and assess for possible focal complications. A lung herniation will seldom heal spontaneously, and early surgical intervention reduces morbidity and mortality. Avoidance of aggravating factors such as smoking and repeated Valsalva are necessary. Classification of the lung hernia is based on location; cervical, intercostal and diaphragmatic; and cause; spontaneous, traumatic and congenital.