Rib fractures present a heavy pain and functional burden in trauma. Our primary aim was to determine return to work in patients with acute rib fractures requiring surgical stabilisation of rib fractures. Our secondary outcomes were pain and quality of life. We also document the first application of the Work Productivity and Activity Impairment Instrument, a validated injury-specific patient-reported outcome measure, for chest wall injury in the literature. A retrospective review was conducted of patients with rib fractures requiring surgical fixation in a single centre between 2008-2020. After applying inclusion and exclusion criteria to ensure relevance, all eligible patients were asked to complete patient reported outcome measure questionnaires. Of 1841 trauma patients with rib fractures, 66 underwent surgical fixation. Thirty-nine patients were eligible and thirty-one completed the questionnaires. Pre-injury and post-injury answers were compared. The number of patients in employment decreased post-operatively from 22 to 16 (p = 0.006). For those that returned to work there was no difference in hours missed but reduced weekly hours and productivity scores. There were significantly more patients with pain and on pain relief. There was a lower quality of life score post-operatively. Approximately 1-in-5 patients who require surgical fixation for rib fractures will not return to work. This is the first chest wall trauma study that uses the Work Productivity and Activity Impairment Instrument, a validated tool for work productivity outcomes. We recommend this instrument as a reliable tool for investigating return to work outcomes in trauma patients.