The symptom of chest pain may be a result or manifestation of somatic dysfunction of the musculoskeletal system. Chest pain is a common chief complaint among patients in a family practice office or in the emergency room. Various intrathoracic and extrathoracic factors may be responsible. The authors describe their experience with one patient in whom osteopathic manipulative treatment was used along with accepted medical tests and therapy to diagnose and treat this patient. If chest pain is effectively diagnosed and promptly treated, OMT can provide the most thorough, cost-effective, and satisfying care available.