Osteoid osteoma is a type of benign bone tumor, which was first described by Jaffe in 1935 [1]. It is a rare condition, which accounts for only 10 to 12 % of primary bone tumors. The most commonly affected sites are the long bones of the lower extremities and the rib involvement is seen in less than 3% [3]. Individuals aged between 5 and 24 years old are the most commonly affected [2]. The main symptom of the rib OO is pain that worsens at night, which may be alleviated by NSAIDs. On chest X ray it looks as osteosclerotic lesion in rib but CT scan has better sensitivity than X ray. Current treatment modalities include surgical excision, as well as less invasive techniques like alcohol ablation. Difficulty during surgery is lesion localisation for which intraopt use of C arm or histopathological examination of excised rib specimen is helpful.