Background: Trauma is a major cause of morbidity and mortality worldwide, and the leading cause of death in the first four decades of life. Rib fractures (RFs)are very common and are detected in at least 10% of all injured patients, the majority of which are as a consequence of blunt thoracic trauma (75%) with road traffic collisions being the main cause. The remaining 25% are due to penetrating injuries. RFs are associated with significant morbidity with increase admission to the ICU and mortality rates as high as 33%. The first published use of US in peripheral nerve block occurred in 1978 when doppler sonography assisted blood flow detection during supraclavicular brachial plexus block. Although the initial technology did not allow for direct nerve visualization this was later corrected in 1994 when advancements in technology allowed the first documented use of US to facilitate visualization of supraclavicular brachial plexus block. Since this time, US use for regional anesthesia has shown increasing popularity, and the utility of US for variety of peripheral nerve blocks continue to emerge. A relatively new procedure, the Erector spinae block (ESPB), first described in 2016 by Forero et al is a technically easy US analgesic procedure that has seen much success in providing pain relief for patients presenting with MRF. In the ESPB, a needle is placed between the transverse process and the erector spinae muscle, and local anesthetic is injected between them, along the fascia of the erector spinae