Providing effective analgesia for acute rib fractures is crucial in avoiding pulmonary complications. Erector spinae plane (ESP) block is an alternative treatment option to neuraxial techniques. ESP blocks have demonstrated pain relief in patients with rib fractures. However, the utilization of unilateral bilevel ESP catheters has not been described. We present a case of unilateral bilevel ESP catheters placed in a patient with flail chest secondary to a motor vehicle accident.