Spontaneous pneumomediastinum is defined as free air in the mediastinum without an explanation or known cause. Late preterm neonates are rarely affected; however, a known risk factor is aggressive resuscitative maneuvers. Moreover, spontaneous pneumomediastinum is a rare cause of neonatal respiratory distress diagnosed in the post-natal period using chest radiography. In contrast, preterm babies with respiratory distress syndrome are associated with pneumomediastinum. The condition is considered benign, and a conservative, non-interventional management approach is widely accepted, with complete gradual resolution as the usual course in affected neonates.