Simultaneous bilateral spontaneous pneumothorax is rare. The incidence is about 1.6% in all spontaneous pneumothorax. Bilateral pneumothorax is most seen in low BMI men without underlying lung disease. We reported a 21-year-old man without trauma, underlying lung disease or pneumothorax history and came to emergency department due to shortness of breath. The chest X-ray showed bilateral pneumothorax. After bilateral thoracostomy with chest tube drainage the condition improved. Right pneumothorax disappeared in third day but Left pneumothorax persisted for 10 days. Finally he was transferred to medical center for surgery.