Thoracic pain in pregnancy has a broad differential diagnosis. The authors report a young pregnant woman with acute pain in the thoracic region due to a rib fracture after a coughing flare. Physicians must be aware of the broad differential diagnosis (and its clinical consequences) of thoracic pain in pregnancy. Radiographic imaging is not necessary if the clinical signs are obvious. If there is no suspicion for underlying pathology other (expensive) diagnostic tests lose their value. Treatment consists of adequate analgesia and no further measures need to be taken.