Superior mesenteric artery syndrome (SMAS) is characterized by an arteriomesenteric duodenal compression commonly resulting from significant weight loss. Vomiting is the most frequent symptom. SMAS can be complicated by massive gastric dilatation. Patients with cerebral palsy have various factors that can predispose them to SMAS. In this paper, we report a rare case of SMAS complicated by duodenal, peritoneal and retroperitoneal emphysema in a patient with cerebral paralysis, referring to the relevant literature. In this case, severe vomiting associated with epilepsy and weight loss may have contributed to the development of duodenal emphysema.