Introduccion: la paralisis diafragmatica se produce por interrupcion en la transmisionmde los impulsos nerviosos a traves del nervio frenico o por perdida de la contractilidad del musculo. Conlleva a atrofia muscular progresiva y distension de la cupula. Puede presentarse bilateral o unilateralmente, siendo esta ultima mas comun; sin embargo, es una afeccion de baja incidencia. Las causas son invasion tumoral del nervio frenico, lesiones quirurgicas, traumaticas, infecciones, idiopaticas, entre otras. Su correccion quirurgica es necesaria cuando hay compromiso respiratorio. Varias tecnicas y abordajes estan descritos para realizar reparacion. No se conocen publicaciones de plicaturas diagramaticas realizadas por videotoracoscopia por dos puertos. Caso clinico : se presenta caso clinico de paciente femenina de 50 anos de edad con paralisis diafragmatica idiopatica. Disnea progresiva, con datos espirometricos sugestivos de patron restrictivo severo. Se realizo satisfactoriamente y sin complicaciones plicatura diafragmatica via toracoscopica por dos puertos. Se comprobo mejoria anatomica y clinica. Conclusion: la plicatura diafragmatica es la tecnica quirurgica de eleccion para la correccion de la paralisis diafragmatica. Se propone la videotoracoscopia por dos puertos como abordaje favorable que permite realizacion del procedimiento operatorio. Rev.cienc.biomed.2013;4(1):142-146 PALABRAS CLAVE Diafragma; Cirugia toracica; Toracoscopia. SUMMARY Introduction : Diaphragmatic paralysis is produced by interruption in the transmission of nerve impulses by means of the phrenic nerve or by loss of the muscle contractility. It entails to progressive muscular atrophy and to distension of the cupola. It can appear unilaterally or bilaterally, being this one the most common; however, it is a condition of low incidence. The causes are tumour invasion of the phrenic nerve, surgical, traumatic and idiopathic lesions and infections, between others. Its surgical correction is necessary when respiratory commitment exists. Several techniques and approaches are described to do repair. Publications about diaphragmatic plication by thoracoscopy by two ports are unknown. Clinical case: It is presented a clinical case of a 50 years old female patient with idiopathic diaphragmatic paralysis, progressive dyspnea with suggestive spirometry data of severe restrictive pattern. Diaphragmatic plication by thoracoscopic way by two ports was carried out satisfactorily. Anatomical and clinical improvements were confirmed. Conclusion: Diaphragmatic plication is the surgical technique of choice to repair diaphragmatic paralysis. The videothoracoscopy by two ports is proposed as a favorable approach that allows the development of the surgical procedure. Rev.cienc.biomed.2013;4(1):142-146 KEYWORDS Diaphragm ; Thoracic Surgery ; Thoracoscopy.