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Background: Spontaneous pneumomediastinum is a rare and benign condition that generally occurs in young generations without any precipitating factor or underlying disease. The purpose of this study is to review our experience in dealing with this entity and detail a reasonable course of assessment and management. Methods: From December 1999 to May 2012, 32 spontaneous pneumomediastinum patients were managed in our hospital. We retrospectively reviewed the result of management. Results: Patients ranged in age from 10 to 38 years, with the mean age of 18.3±5.6 years. Twenty-five patients were men and seven were women. Initial WBC count was 10,039±2,993/μL and thirty-one patients underwent computed tomography. Twenty-two patients underwent esophagography and results were shown to be normal. Twenty-five patients were admitted in the hospital and the mean duration of admission was 3.4±2.0 days. All patients were managed conservatively and discharged without any complications. Conclusion: Spontaneous pneumomediastinum is a benign condition combined with mild inflammatory signs and secondary causes must to excluded to avoid unfavorable outcomes and select proper management modality