Pneumomediastinum is identified as the presence of air within the mediastinal spaces. Various etiologies are responsible for pneumomediastinum, including intrathoracic or extrathoracic and traumatic or nontraumatic etiologies.

Comprehensive history taking and clinical examination should exclude any secondary causes of pneumomediastinum, such as; pneumothorax, recurrent vomiting, rupture of air bulla, air trapping in asthmatic patients, or any traumatic or iatrogenic causes.

This patient presents with a 3-week history of chest pain that aggravated in the last two days. Physical examination reveals crepitations in the neck region. The patient denies any medical illness, surgical intervention, or traumatic event.

On further questioning, the patient revealed that the pain started after he had played at the gym (lifting weights) 3 weeks earlier. After excluding any other secondary etiology by radiological and clinical examinations, this lifting us with lifting weights as the prober cause for his presentation.