Case: A patient sustained flail chest and diaphragmatic rupture with perforation of the stomach. She underwent gastrorrhaphy with chest lavage. She developed empyema and underwent decortication. Intraoperative cultures grew bacteria and yeast. She failed extubation because of pain despite maximal medical therapy. She underwent surgical stabilization of rib fractures (SSRF). Intraoperative cultures remained positive. She was extubated 9 days after SSRF. She was ultimately discharged to home with a total of 2 months of antibiotics and no need for plate removal. Conclusion: The presence of infection should not be considered a contraindication to SSRF in patients who are mechanical ventilation dependent due to flail chest.