Background: Minor blunt neck injury trauma is a relatively common condition which can be potentially life-threatening in only rare circumstances. Pneumomediastinum may develop in up to 10% patients who have sustained blunt cervical or thoracic trauma and may be a significant cause of morbidity and mortality in affected individuals because of the associated damage to the oesophagus, larynx or trachea. Management of this condition varies from conservative approach with close observation and antibiotherapy to surgical intervention, depending on the extent and severity of aerodigestive injuries. Conclusions: A blunt neck trauma accompanied by subcutaneous emphysema and pneumomediastinum secondary to an accident, its radiologic appearance, clinical presentation, and the options for initial management in the emergency department need a special attention.