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A 46-year-old female with intraventricular space occupying lesion was posted for craniotomy and excision of the same. Immediately following routine induction of general anaesthesia and a bougie-guided intubation, she developed increased airway pressures and desaturation associated with a decreased air entry on the right side of the chest suggestive of a right-sided pneumothorax which was confirmed with radio imaging and following the placement of chest drain the saturation improved and airway pressures decreased. To be faced with a pneumothorax following an intubation could be surprising for a non-suspecting anaesthesiologist and it can have important implications especially in neurosurgical cases where a tight control of intracranial pressure is warranted. Hence, this case report emphasises the need for a high index of clinical suspicion for proper management and safe patient outcome.

A case of pneumothorax following bougie-guided intubation in a patient undergoing excision of an intraventricular space occupying lesion