Spontaneous subcutaneous with mediastinal emphysema is a rare but potentially dangerous complication during delivery. The condition was noted in a 21 year-old, gravida 1 para 1, female after vaginal delivery of a 3380 gm male using vaccum extractor in the second stage of labor. Physical examination showed bilateral subcutaneous emphysema over face, neck and anterior chest wall. She was admitted and administered with nasal oxygen. The outcome was good and the patient asked for discharge two days after admission.