The cottage loaf sign is a radiological finding associated with diaphragmatic rupture, often observed on imaging studies such as computed tomography (CT) or Magnetic Resonance Imaging (MRI).[1] This sign refers to the appearance of herniated liver into the thoracic cavity, with a characteristic "stacked" or "two-tiered" morphology resembling a traditional British cottage loaf—a smaller, rounded structure situated atop a larger one. It is a key indicator of diaphragmatic injury, typically resulting from blunt or penetrating trauma.[2]