Three patients, 2 women aged 30 and 64 respectively and one man aged 75, with upper abdominal pain (right in the youngest patient and left in the other 2 patients), experienced tenderness over the lowermost ribs, especially at the end of the lowest floating rib. The diagnosis 'painful rib syndrome' was established once other possible conditions had been excluded. Following an explanation of the condition and some advice about posture, the symptoms disappeared. Painful rib syndrome can be a cause of chronic debilitating pain located in the left or right upper quadrant of the abdomen. The pain is movement and posture dependent. The syndrome is often not recognised. No data on the prevalence are available.