Introduction: Congenital Diaphragmatic hernia (CDH) is usually detected antenatally or after birth. However, it can go undetected and present later on in life with multiple complications or found as an incidental finding during an acute infection. Case presentation: A previously well five-month-old baby presented with a history of fever and shortness of breath for one day duration. On examination there was respiratory distress associated with marked reduced air entry on the left side. X-ray was urgently ordered which showed a Left sided diaphragmatic hernia with a mediastinal shift to the opposite side complicated with a possible gastric volvulus. Baby was kept nil by mouth and transferred to the PICU to be intubated and ventilated following persistent distress. Surgery was performed and an obstructed gastric volvulus was detected. However, no bowel necrosis or lung hypoplasia was noted. Post-operative period was uncomplicated and the child recovered well. Discussion: CDH needs to be considered as a differential diagnosis regardless of the age in the paediatric population when there are clinical signs and symptoms that can tally with a diagnosis of CDH like marked reduction of air entry in a particular side. The child may present following a trigger like an infection. Any delay in treatment can lead to severe complications. Hence, prompt investigations and the necessary management needs to be done.