Flail chest is the most serious form of blunt thoracic trauma that occurs as a result of fracture of three or more ribs from at least two places or sternal fractures and/or separation of costochondral junctions. Existence of life-threatening physiopathological changes almost always affects the clinical status of the patients. Typically the fractured segment moves in the interior and exterior directions during inspirations and expirations, respectively and this paradoxical motion is called as flail chest. Non-operative treatment approaches are usually preferred for the flail chest cases. However, surgery constitutes the unavoidable treatment procedure in the existence of severe chest wall deformities, unstable ventilation dynamics, lung and diaphragmatic injuries and prolonged mechanical ventilation. Here we present a case of traumatic flail chest in a patient with traumatic severe chest wall deformity treated by chest wall reconstruction with AO-ASIF [Arbeitsgemeindschaft fur Osteosynthesefragen (Association for the Study of Internal Fixation)] osteosynthesis plaque.