Complications of thyroidectomy are common and few of these could be life threatening. Although rare, the delayed tracheal rupture is one such complication and needs to be managed promptly. A male patient presented with neck swelling and on evaluation diagnosed to have papillary carcinoma thyroid T4a N1b M0. Patient underwent total thyroidectomy and neck dissection. On post-operative day 5, he developed subcutaneous emphysema. The subcutaneous emphysema was managed non-surgically with close observation and took 6 days to resolve completely. Management algorithm has been formulated after literature review. Delayed subcutaneous emphysema following thyroidectomy can be managed non-surgically in selected cases with mild emphysema and non-progressive course.
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