The pain under the middle of the rib cage may be caused by trauma, cardiogenic diseases, respiratory diseases and so on. 1. Trauma: If the chest wall soft tissue injury or rib fracture is caused by trauma, it will easily lead to pain under the middle of the rib cage. 2. Diseases of cardiac origin: such as coronary atherosclerotic heart disease, myocarditis, pericarditis, endocarditis and other diseases, these conditions will lead to coronary artery stenosis, ischemia and spasm, which will lead to pain in the middle of the rib cage. 3. Respiratory diseases: when patients have different degrees of pneumothorax, chest infection, large-scale pneumonia, pleurisy and other diseases, they will have pain in the middle of the rib cage. When the patient has pain under the center of the rib cage, he should go to the hospital in time, clarify the cause of the disease, and follow the doctor’s instructions for treatment.