The treatment of bilateral thoracoabdominal hiatal hernia is related to the size of the diaphragmatic defect and the severity of the patient’s condition: a small number of newborns and infants with large diaphragmatic defects and more severe conditions need to be operated on as soon as possible after adequate preoperative preparations, while most of the older infants with small diaphragmatic defects and less severe conditions can be operated on at a later date. 1. A small number of newborns and infants with bilateral thoracoabdominal hiatal hernias with large diaphragmatic defects leading to pulmonary hypoplasia and pulmonary hypertension are in severe condition and need to be operated as soon as possible after adequate preoperative preparations, and laparoscopic transabdominal diaphragmatic repair can be chosen. 2. Most of the older children with bilateral thoracoabdominal hiatal hernia can be treated with elective surgery because of smaller diaphragmatic defects, less herniation of abdominal contents into the thoracic cavity, and fair lung development. Thoracoscopic transthoracic diaphragmatic repair is an option. How to treat bilateral thoraco-abdominal hiatal hernia, it is recommended to go to the hospital for further consultation.