It is expected that over the next decade the population of older adults in the United States will increase dramatically. As the older adult population increases, the number of older adults involved in traumatic accidents is also expected to climb. The older population is at an increased risk for complications and poor outcomes following trauma. Practitioners caring for these older adults will need to use evidence-based practice guidelines in an attempt to improve outcomes. This article provides a clinical guideline for the assessment and management of pain in older adults with traumatic rib fractures, and an approach for pain assessment, which includes the use of the numeric rating scale as well as incentive spirometry. The modalities used for pain management include epidural analgesia, paravertebral analgesia, patient controlled analgesia, and the use of oral opioids.