Spontaneous pneumomediastinum or Hamman syndrome is a rare clinical entity that emergency physicians may encounter. It is characterized by the presence of free air in the mediastinum unrelated to overt trauma. The cause of this condition is rupture of terminal alveoli as a result of increased intra-alveolar pressure against the background of chronic lung disease. Hamman syndrome presents with nonspecific symptoms such as: chest pain, difficulty breathing, neck puffiness, rhinolalia, dyspnea, vomiting, fever, dysphagia, hoarseness, tachycardia, tachypnea, and restlessness. This condition most often has a favorable prognosis, but in rare cases can lead to compression of the main vessels and trachea. The main method of diagnosis is chest radiography in two projections. Otorhinolaryngologists should be aware of Hamman syndrome, since the main complaint of the patient may be complaints from the ENT organs. In this case, a detailed collection of history will help to establish a correct diagnosis and choose the right tactics for the management of the patient. This article presents a clinical case of spontaneous pneumomediastinum in a patient with a long history of smoking, diagnosis and treatment of the condition in an urban multidisciplinary hospital.