Pneumomediastinum is defined by the presence of air in the mediastinum. Here we describe a patient with spontaneous pneumomediastinum and extensive subcutaneous emphysema. An 18-year-old woman presented to the emergency department complaining of cough and neck pain. Cervical inspection revealed enlargement of the anterior region and crepitation was heard on palpation of that region and supraclavicular fossa. Performed chest CT confirmed the existence of pneumomediastinum with further dissection of air into the neck. Pneumomediastinum is a rare and generally benign condition.