Abdominal pain accounts for almost 1.5% of office visits and nearly 5% of emergency department admissions each year in the United States. In 2% to 3% of patients with chronic abdominal pain, the pain arises from the abdominal wall. Postoperative abdominal wall pain is chronic, unremitting pain unaffected by eating or bowel function but exacerbated by postural change. A localized, tender trigger point can be identified, although pain may radiate over a diffuse area of the abdomen. Thorough history and physical examination can distinguish abdominal wall pain from visceral intra-abdominal pain. A positive Carnett’s sign favors an abdominal wall pain generator and not a visceral source. Injection with a local anesthetic and steroid at the area of pain may provide relief and can function also as a diagnostic test for abdominal wall pain. Refractory pain may be treated with chemical neurolysis, radiofrequency ablation, peripheral nerve stimulators, or neurectomy.