The term barotrauma refers to the rupture of the pulmonary alveoli due to pressure changes along with entry of air into the surrounding alveoli (pneumothorax) or into mediastinum (pneumomediastinum). It can also result in subcutaneous emphysema. It is a common complication seen in patients on mechanical ventilation that can be life threatening. In normal breathing process, negative intrathoracic pressure plays the role while in mechanical ventilation, positive intrathoracic pressure is used to assist breathing which results in barotrauma. Two most common symptoms seen are chest pain and shortness of breath. It is more common in people suffering from lung disorders like asthma, COPD, interstitial lung disease and acute respiratory distress syndrome. Management includes chest tube insertion in pneumothorax, surgical decompression, reducing positive pressure and treating underlying lung diseases.