Symmetrical pain in both ribs may be caused by costochondritis, pleurisy, intercostal neuralgia and so on. 1. Costal chondritis: Costal chondritis is an inflammatory reaction between the ribs and the rib cartilage, which can be divided into non-specific costal chondritis and septic costal chondritis. The former is caused by local external forces, destruction of the immune system and chronic strain; the latter is mostly related to systemic infection caused by bacterial infection. When the inflammatory reaction involves both ribs, the clinical manifestation can be symmetrical pain on both sides of the ribs. 2. Pleurisy: lung infection, rheumatic diseases can involve the pleura and lead to pleurisy, when the inflammation involves both sides of the pleura, it can lead to symmetric pain on both sides of the ribs. 3. Intercostal neuralgia: virus, bacteria and other infections of intercostal nerve, tumor compression of intercostal nerve may cause intercostal neuralgia. When both sides are affected at the same time, radiating symmetrical pain can occur on both sides of the ribs. Thoracic spine disease can also cause bilateral symmetric rib pain. It is recommended that the patient should consult the doctor in time, improve the examination, clarify the cause of pain, and standardize the treatment in time.