Pain following cardiac surgery via median sternotomy may be challenging to treat and, if managed inappropriately, can lead to respiratory complications, prolonged hospital stay and persistent pain. The analgesic options include paracetamol and NSAIDs, opioids and adjuvants like gabapentin. Opioids may lead to side effects like nausea, vomiting, constipation, urinary retention, pruritus and respiratory depression. This could prolong recovery and delay discharge. Ultrasound-guided regional blocks like thoracic epidural, paravertebral, Interpectoral plane block, serratus anterior block, and erector spinae have been described as beneficial. The peripheral regional blocks have lower incidences of complications and cause fewer hemodynamic disturbances (No sympathetic block) and less motor blockade. We have discussed the analgesia options for Open Heart Surgery through median sternotomy.