Flexible bronchoscopy is a common and safe outpatient procedure, with complications arising in less than 1% of cases. The case presented herein details the occurrence of pneumomediastinum, pneumopericardium, pneumoperitoneum, interstitial lung emphysema and subcutaneous emphysema during flexible bronchoscopy. Although these complications have been reported individually in various circumstances, they have not been reported concomitantly in this setting. Recovery was rapid and complete, requiring only supplemental oxygen and monitoring. After a literature and chart review, the authors postulate that the complications were not a direct result of bronchoscopy but rather the simple act of placing an oxygen delivery cannula in a patient with possible prior trauma to the site.