This case highlights the successful use of a 60-day intercostal peripheral nerve stimulator (PNS) for chronic post-mastectomy and post-thoracotomy neuralgia. A 62-year-old woman with refractory chest wall pain (T4–T6 dermatomes) experienced only temporary relief from intercostal nerve blocks, providing 80–100% pain reduction for up to six months. A temporary percutaneous PNS system was then implanted along the left T5 intercostal nerve under ultrasound guidance. The patient reported greater than 80% pain relief, discontinued opioid use within two weeks, and maintained functional improvement and reduced allodynia for three months following explant. This case demonstrates the efficacy, safety, and durability of short-term intercostal PNS for focal neuropathic pain following thoracic and breast surgery.