Spontaneous pharyngeal perforation is a rare condition with nonspecific symptoms that can mimic more common airway or esophageal disorders. Limited clinical awareness may delay diagnosis, increasing the risk of complications. This case describes an unusual pharyngeal rupture triggered by suppressed sneezing.A 41-year-old man presented to the Emergency Department with hoarseness, odynophagia and dyspnea following multiple episodes of suppressed sneezing. Several hours later, the patient developed anterior neck pain and bilateral cervical swelling, following forced body position leaning forward, because of dyspnea. There was no history of trauma or predisposing factors. Physical examination revealed bilateral neck swelling with subcutaneous emphysema. Fiberoptic examination showed mild larynx edema and hemorrhage of the right vocal fold. Laboratory tests were unremarkable. Computed tomography of the neck and chest, along with esophageal fluoroscopy, showed subcutaneous emphysema involving the neck, face and pneumomediastinum and a suspected defect above the left margin of the epiglottis.The patient was admitted to thoracic surgery department for observation and managed conservatively with analgesia, intravenous amoxicillin/clavulanate, fluid therapy, and stress ulcer prophylaxis. Follow-up chest radiography showed no progression of emphysema, with well-aerated lungs. Symptoms resolved progressively, and the patient was discharged after four days. Strengths of management included early imaging and multidisciplinary involvement. Limitations were the inability to directly visualize the perforation and the absence of long-term follow-up data.Pharyngeal perforation is more commonly associated with trauma, instrumentation, or severe vomiting. Cases related to suppressed sneezing are rare, with only limited reports in the literature. This case highlights a low-energy, self-induced mechanism leading to clinically significant injury.This experience underscores the need for clinical vigilance when evaluating acute cervical emphysema without trauma. Early imaging and interdisciplinary communication are critical. Conservative management may be sufficient in stable patients, but careful monitoring is essential.The case illustrates how subtle symptoms can conceal rare but potentially serious pathology. Coordinated care among primary care physicians, ENT doctors, radiologists and thoracic surgeons enabled timely diagnosis and safe management.This case broadens awareness of spontaneous pharyngeal perforation as a possible consequence of suppressed sneezing and highlights the importance of multidisciplinary collaboration to ensure prompt diagnosis and favorable outcomes.