Although a rare complication of labor, subcutaneous emphysema and pneumomediastinum (Hamman's syndrome) must be considered in the parturient complaining of chest or neck pain, dysphagia, or shortness of breath. With conservative management, the prognosis is favorable. The case presented is the first of Hamman's syndrome complicating the labor of a twin gestation. The pathophysiology, symptoms, and management guidelines for the syndrome are reviewed.