Congenital diaphragmatic hernia (CDH) is a group of disorders where abdominal contents protrude into the chest. The prognosis depends on the contralateral lung volume. The authors evaluated a case of left sided diaphragmatic hernia that was diagnosed at 32 week, and confirmed by MRI. Sonography based Lung to Head circumference ratio (LHR) was calculated. The case was managed at a tertiary care centre where the newborn was immediately shifted to the pediatrician and pediatric surgeon and was operated. Antenatal sonography is the primary modality to diagnose CDH. LHR based on sonography is the key to predict pulmonary hypoplasia and, an MRI is additive. The management needs a multidisciplinary approach.