Pain after cardiac surgery is very common and can be a challenging issue, it is crucial to control postoperative pain to reduce morbidity and mortality, Due to the complexity of cardiac surgery and the presence of multiple comorbidities in patients, still pain control remains difficult and requires a meticulous, individualized proper plan. In this chapter, we present the pathophysiology and factors contributing to postoperative cardiac surgical pain, then we discuss different analgesic modalities for pain management whether through pharmacological or non-pharmacological approaches.