PURPOSE OF REVIEW: This narrative review evaluates the efficacy and clinical applications of the rhomboid intercostal nerve block (RINB) for postoperative pain management. With growing interest in ultrasound-guided regional anesthetic techniques, RINB has emerged as a promising approach for thoracic, abdominal, and breast surgeries. We aim to synthesize current evidence on its analgesic effectiveness, opioid-sparing potential, and comparative advantages. RECENT FINDINGS: An ultrasound guided rhomboid intercostal nerve block (RINB), delivers anesthetic into the intercostal muscles to relieve chest wall pain, including thoracoscopic, abdominal, and mastectomy surgeries. Anesthetic delivered between the rhomboid major and intercostal muscle demonstrated clinical efficacy resulting in improved patient recovery, post-operative analgesia, and reduced opioid consumption. Clinical studies have demonstrated that RINB has comparable and even more effective analgesic efficacy of previously utilized ultrasound guided nerve blocks with an excellent safety profile in patients receiving thoracoscopic, abdominal, and mastectomy surgeries.