Sternotomy pain is a common complication after cardiac surgery. We present a 77-year-old patient with severe acute sternal pain after coronary artery bypass graft surgery who was successfully treated with a novel peripheral regional anesthetic technique, the pecto-intercostal fascial block. This interfascial plane block may represent an effective regional anesthetic component of a multimodal analgesic strategy for cardiac surgery patients who suffer from significant pain after a median sternotomy and are typically anticoagulated.