The case describes a young girl developing cervicofacial emphysema after fall. She presented in emergency with gradually worsening upper body swelling without any sign of distress. Swelling was found on the right side of the face, all around the neck and right arm with crepitus in all these areas. CT scanning of head, neck and chest were performed and a small area of communication between nasopharynx and the trapped air of subcutaneous emphysema was seen. Video-endoscopy of the pharynx showed a tear in the nasopharyngeal mucosa acting as a one way valve leading to the development of cervicofacial emphysema.