Introduction: Lung herniation following blunt chest trauma is extremely rare and only a few hundred cases of this pathology have been reported in the English language medical literature. This type of lung hernia is divided into intercostal, parasternal, or supraclavicular subtypes based on the exact location of the chest wall defect. Traumatic intercostal lung hernia is even more uncommon. Delayed presentation of a traumatic lung hernia has been reported in two cases in the medical literature where cases had a delayed presentation of 2-29 days. Case Presentation: We present a case of 72-year-old white male who had a delayed presentation of an intercostal post traumatic lung hernia (PTLH) 50 years after severe blunt chest trauma. Conclusions: This is a rare case of a delayed presentation of a traumatic intercostal lung hernia. Based on our literature search, this case seems to be the first reported case with such a long delay prior to presentation. We suggest that in patients with even a remote history of blunt chest trauma, a physical examination and preoperative evaluation including assessment for possible PTLH be considered before patients undergo positive pressure ventilation. We also suggest that PTLD be considered in the differential diagnosis for patients with blunt traumatic chest injuries and rib fractures.