Acute sinusitis including maxillary sinusitis is one of the most common complications of acute upper respiratory tract infections. The "gold standard" in the diagnostics and treatment in cases at positive interview, positive results of rhinoscopy, X-ray examination and negative pharmacological treatment is sinus puncture. Method is cheap, simple but charged minimal risk of complications, so, not recommended as method from choice for practice diagnostics of first cast. The paper presents case of intramuscular, subcutaneous, retropharyngeal region and in front of vertebral column regions emphysema in 61-year-old man after maxillary sinus puncture.