Introduction: Pneumopericardium is defined as a collection of air or gas in the pericardium, and considered a rare and innocuous condition. It may progress to tension and cardiac tamponade and may become life-threatening in many instances. In this publication, we will share the case of a pneumopericardium which occurred for middle-aged women treated for liver carcinoma after a laparotomic surgery. Discussion: Pneumopericardium was once defined as a collection of air or gas in the pericardium, and considered a rare and innocuous condition. The most common etiology of pneumopericardium is blunt trauma. Also, air may dissect into the mediastinum from the retroperitoneal space following the perforation of a hollow viscous or infection with gas-producing organisms. Other causes of pneumopericardium include iatrogenic complications during chest or abdominal surgeries. Diagnosis of spontaneous pneumopericardium can often be made with a formal two-view Chest X-Ray or CT scan. The treatment of air in the pericardial space depends on the type of pneumopericardium present and whether or not there is associated cardiac tamponade. However, tension pneumopericardium can be effectively relieved by pericardiocentesis or tube decompression and the underlying cause subsequently determined. Conclusion: In conclusion, surgeons should be aware of the possibility of pneumopericardium for patients with chest pain after a laparoscopic procedure and look for electrocardiographic abnormalities. It is important to outline the important role of the chest CT scan to search for pneumothorax or pneumomediastinum.