Intercostal neuralgia is a rare but potentially debilitating condition that manifests as neuropathic pain in any rib space. This pain can typically be treated with typical mainstays of neuropathic pain treatment, such as over-the-counter analgesics, gabapentinoids, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, and opioids. However, as detailed in this case, patients can have refractor pain despite the use of these mainstays of treatment. In these patients, peripheral nerve stimulator (PNS) placement can be a possible treatment modality. In our case detailing a 75 year old male with refractory intercostal neuralgia, we have shown that PNS placement for this indication can provide analgesia in this debilitating condition.