Abstract
Accessory ribs are rare anatomical variations, typically cervical or lumbar, with intrathoracic accessory ribs being particularly uncommon. These anomalies are often asymptomatic but can cause issues like thoracic outlet syndrome. This case report describes a 36-year-old woman who was incidentally found to have an intrathoracic accessory rib on a chest X-ray. Conservative management was advised as the rib did not affect any vital structures and the patient was asymptomatic. The case highlights the importance of recognizing rare anomalies through imaging to avoid unnecessary workup.