Lung hernia is a rare finding described as the protrusion of lung tissue outside the pleural cavity. Lung perfusion scintigraphy is used for pre-operative assessment of high-risk patients prior to pneumonectomy This case report presents a case of an apical left lung hernia detected in a lung perfusion scan prior to elective pneumonectomy in a seven-year-old girl with pulmonary tuberculosis destroyed right lung and compensatory left lung hyperinflation.