Objectives: The objective of this study was to study the results of the largest prospective series to date of xiphodynia patients treated by surgical xiphoidectomy. Summary of Background Data: Xiphodynia is a condition of recurrent and often debilitating severe upper abdominal or sternal chest pain. A retrospective analysis was conducted of 40 patients undergoing xiphoidectomy from January 2014 to January 2017. Methods: Preoperative and postoperative pain scales were measured, by using a standardized Wong-Baker visual pain scale, with a reported zero as no pain and 10 as worse pain. Statistical analysis of pre- and post-operative pain scale were recorded and statistical analysis completed by using a nonparametric Mann–Whitney U. The preoperative pain scale for the patient’s ranged from the level of 9 to 10 (mean: 9.9). Results: The postoperative pain scale was rated between zero and 2 (mean:,1). There was a significant improvement in pain rating from preoperative to postoperative with a P . 0.024. All of the sports injury patients (n ¼ 9) were back to full activity 4 to 6 weeks after the procedure. Conclusions: Xiphoidectomy can be an appropriate treatment modality for intractable cases of severe xiphodynia after failure of more conservative treatments. Patients with recurrence of severe, disabling pain and disability appear to benefit the most from a surgical approach based on the results of this study.