•Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) is a common complication following abdominal surgeries, but often under diagnosed and under treated.

•ACNES often presents with localized pain to small area with possible radiation and exacerbation with activation of abdominal musculature.

•66-year-old female with two years of constant lower abdominal pain along prior abdominal incision, radiating to the back.

•Prior failed sacroiliac joint and lumbar epidural steroid injections, MRI grossly normal.

•Ilioinguinal block and ablation provided three months of relief, diagnostic bilateral anterior cutaneous nerve blocks provided 85% relief for 1-2 weeks.

•Following 60-day peripheral nerve stimulator, patient reported 90% relief and, at last follow-up 10 weeks after lead extraction, patient reported sustained relief.

•Common methods of management include medication, trigger point injections, nerve blocks, and neurolysis.

•Referred visceral pain from somatic sites due to convergence of nociceptive C-fibers at lamina I neurons.

•Peripheral nerve stimulators inhibit pain/modulate neurons at dorsal horn, disrupt nociceptive afferent fibers, and downregulate inflammatory mediators.

•Peripheral nerve stimulators can be a safe and effective treatment for ACNES.