Introduction: Many poly-trauma patients sustain chest wall injuries. Flail chest is considered one of the uncommon injuries that may happen in traumatized patients and may increase morbidity and mortality in polytrauma patients. Pulmonary contusion, mechanical ventilation, pneumonia, sepsis and poor pain control are expected to be common complications in patients sustaining chest wall injuries. We hypothesize that the use of epidural analgesia can lead to improved clinical outcomes in this group of patients.