Spontaneus pneumomediastinum (SP) is an infrequent but usually benign pathology. Its main clinical manifestations are thoracic pain, dyspnea and subcutaneous emphysema. We describe the clinical findings of 4 SP patients, identified in the context of an A H1N1 influenza virus epidemic. All the patients were young and all of them required initial medical attention for asthma exacerbation. The most frequent symptoms and signs to detect SP were cervical pain and subcutaneous emphysema; chest radiography helped to confirm the diagnosis. Concomitant A H1N1 influenza virus infection was documented in two patients. The treatment was focused in the basic pathology; two patients were placed on oseltamivir, whereas the two others just had expectant management.