Endotracheal intubation can lead to iatrogenic trauma to the upper airways. Superficial mucosal tears in the mouth, pharynx, or larynx are common and can cause secondary infection and acute respiratory distress due to massive air leak. We report a patient who sustained a severe 5-cm tracheal laceration and subcutaneous emphysema after intubation. She was successfully weaned from the ventilator after adjustment of the endotracheal cuff, therapy with broad-spectrum antibiotics, and continuous airway humidification.