Background: Post-thoracotomy pain is a significant issue in thoracic surgery. This work evaluated the effectiveness of ipsilateral thoracic ultrasound (US)-guided erector spinae plane block (ESPB) in controlling post-thoracotomy pain. Methods: This retrospective study was conducted on 20 patients aged 18 to 60, classified as American Society of Anesthesiologists (ASA) physical status II and III, scheduled for thoracic surgery. Patients received ESPB using 15 ml of 0.25% bupivacaine under US guidance, followed by epidural anaesthesia. Postoperative pain management involved epidural infusion of 0.25% bupivacaine and rescue analgesia as needed. Results: Heart rate measurements at 6 h and mean arterial blood pressure measurements at 2h, 6h and 24h were significantly lower than 1h (P <0.05). Oxygen saturation measurements at 2, 6, 12 and 24 h were significantly elevated compared to 1h (P <0.05). Visual analogue scale scores at 2h and 6h were significantly decreased compared to 1h (P =0.003 and 0.002, respectively). The mean value (±SD) of intraoperative fentanyl dose was 202.5 (± 37.96) µg. The mean value (±SD) of time to 1st rescue analgesic was 6.9 (± 7.66) h. The total rescue analgesic doses' mean value (±SD) was 1.9 (± 0.75). The mean value (±SD) of the number of postoperative epidural bolus was 0.9 (± 0.72). Conclusions: Ipsilateral thoracic US-guided ESPB effectively manages post-thoracotomy pain in thoracic cancer surgeries as it improves pain scores and maintains hemodynamic stability.upstream. Additionally, for all models, the material harvesting pit was moved downstream.