The coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2, has resulted in widespread global morbidity and mortality. Herein, we report a case of spontaneous pneumomediastinum and subcutaneous emphysema of the neck and chest wall in a patient hospitalized with respiratory failure due to COVID-19. Since our patient was not treated with mechanical ventilation, this case demonstrates that spontaneous pneumomediastinum can appear in patients with COVID-19 regardless of barotrauma and highlights the pathophysiology of this complication. [ABSTRACT FROM AUTHOR]