A case of spontaneous pneumomediastinum with cervical emphysema is reported. Spontaneous pneumomediastinum may complicate processes that decrease pulmonary interstitial pressure or increase intraalveolar pressure leading to alveolar rupture. Free air may then tract along blood vessels and decompress into the soft tissues of the neck. Clinical symptoms include neck and chest pain, dysphonia, and shortness of breath. Care is supportive unless the patient has a history of trauma or foreign body aspiration. Symptoms typically resolve within days.