Pain following thoracotomy incisions, particularly involving multiple rib resections, can be devastating. We report our experience using erector spinae plane block with catheter placement for perioperative pain management in a 16 year old patient with Ewing sarcoma. The patient required major thoracic surgery involving resection of the 7th, 8th, 9th and 10th ribs and part of the diaphragm to remove the tumour, followed by mesh reconstruction. Ultrasound guided erector spinae plane block is a simple technique that can provide excellent static and dynamic pain control following major thoracic surgery in adolescents., (Copyright © 2023 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)