Spinal epidural emphysema is rare, and only a few cases have ever been reported. A 18 year-old man was admitted for neck and chest pain for 3 days. Before admission he experienced rhinorrhea and severe cough. Physical examination revealed wheezing on whole lung field and subcutaneous emphysema over the upper portion of the chest and neck. Chest radiograph showed pneumomediastinum ajdn subcutaneous emphysema in the neck and chest CT images demonstrate a free air in the prevertebral fascia. With coservative management, the patient's condition and the pneumomediastinum improved. The patient was discharged to home on the fourteenth day.