Background: Rib fractures are a common and important injury, with significant risk of poor outcomes, including mortality. There is no consensus on which risk factors are predictive of outcome, despite several scores being developed. Aim: The aim of this study is to identify serum biomarkers that may be valuable in the assessment of risk of poor outcomes in rib fracture patients. Methods: A systematic review was performed in accordance with the PRISMA guidelines. Studies which investigated clinically useful serum biomarkers in the setting of blunt chest trauma were included. The quality of included studies was evaluated according to the Quality in Prognostic Studies (QUIPS) tool. Results: Twelve articles were included in this review. Three investigated aspects of blood gas analysis; four investigated haemoglobin or lymphocyte counts; three investigated troponin and one investigated brain natriuretic peptide (BNP). A narrative analysis was performed, given the degree of heterogeneity. Conclusion: Base deficit, lactate, lymphopenia, troponin and BNP have been investigated as clinically useful and accessible biomarkers in the setting of chest trauma, with all showing some association with mortality. All may offer some predictive value; however further high quality, prospective studies are required to confirm this.