Subcutaneous emphysema and pneumomediastinum are an extremely rare complications of adenoidectomy. Although the majority of cases are self-limiting and benign, it may lead to life-threatening complications, such as tension pneumothorax. Symptoms include fever, neck pain, chest pain, dyspnea and odynophagia. We experienced a rare case in which subcutaneous emphysema and pneumomediastinum developed in a healthy 11 years old boy after adenoidectomy only, it was evident by clinical and radiological examinations. This case to our knowledge is the first case of subcutaneous emphysema and pneumomediastinum linked to adenoidectomy only in the English literature. Prevalence, possible pathogenic mechanisms and treatment options are discussed.