Rib fractures due to blunt chest trauma is a painful condition with high morbidity and mortality that is twice as high in the elderly compared to young people. If adequate analgesia treatment is not provided, respiratory complications, the need for mechanical ventilation and the length of stay in intensive care unit (ICU) may increase. Erector spinal plane (ESP) block is a regional anesthesia method that can provide effective analgesia in unilateral thoracic region. Here, ESP block, which is used successfully in pain management of a critically ill oldest-old patient with multiple rib fractures in ICU, is presented