Tonsillectomy is one of the most commonly performed surgical procedures among patients in the Otolaryngology Department for different indications. Although it is a relatively safe surgical procedure, tonsillectomy may be accompanied by rare complications, such as surgical emphysema, which is considered a fatal complication if incorrectly managed or misdiagnosed. We report a case of surgical emphysema following a routine tonsillectomy, as well as conduct a retrospective review of every such case published in English between January (1, 2000(1, to March 30, 2020. The aim of this case report was to report the pathogenesis, clinical presentation, treatment and management outcomes of patients with surgical emphysema after tonsillectomy.