Hernia of the lung is an uncommon clinical entity. The majority of reported hernias are acquired traumatic thoracic hernias. A case of an acquired spontaneous hernia occurring through an old anterior thoracotomy scar is presented. We believe pathogenesis of this hernia was the result of increased intrathoracic pressure secondary to tracheobronchomegaly and anterior-posterior collapse of the trachea during expiration. The hernia was successfully repaired by a video-assisted thoracic surgical (VATS) technique using prolene mesh and a hernia stapler similar to the technique used in repair of an inguinal hernia.