Background: Breast reconstruction is a vital component of the overall treatment plan of breast cancer patients. Surgical breast reconstruction is not only desired by most patients, but is recommended by law in many countries. Aim of the Work is to compare between partial resection and complete resection of costal cartilage in breast reconstruction by DIEP flap as regard postoperative pain mainly and other factors as operative time, blood loss, blood transfusion, and hospital stay. Patient and Methods: Forty patients were recruited in this study and were divided into 2 groups, 20 patients underwent breast reconstruction by DIEP flap with partial resection of costal cartilage and 20 patients underwent breast reconstruction by DIEP flap with complete resection of costal cartilage. Results: DIEP flap with partial resection of costal cartilage does in fact cause less postoperative pain than DIEP flap with complete resection of costal cartilage. Conclusion: The DIEP flap is an excellent choice for breast reconstruction, and is usually the first choice of flap for breast reconstruction in our practice. Over the past 3 years in our practice it has shown to be safe and reliable and provide a breast reconstruction with a superior long-term result with minimal donor site morbidity.