Chilaiditi syndrome is rare, often challenging to diagnose and difficult to treat. In general, patients have a long history of symptoms from early childhood. Emergency surgery is usually performed in the case of volvulus or obstruction. Detorsion, colopexy or partial colonic resection have been proposed. However, these methods may lead to a recurrence of the disease. In this article we present a patient with Chilaiditi syndrome who had a single-stage subtotal colectomy and anastomosis. A 20-year-old man was referred to hospital in February, 2004. He had a long medical history but no surgical history. Episodes with emergency visits were documented over the previous 3 years. Chilaiditi sign was seen on the upright abdominal radiograph as free air under the right diaphragm caused by the interposition of the transverse colon between the liver and the diaphragm. The patient underwent a subtotal colectomy with an anastomosis between the ascending colon and the rectum. To our knowledge, this is the only reported case of a single-stage subtotal colon resection associated with Chilaiditi syndrome.