Neonatal subcutaneous emphysema is a very rare complication of endotracheal intubation or surgery; however, only a few cases of spontaneous subcutaneous emphysema were reported in a neonate. The patient presented in respiratory distress with a low SaO2; however, no clinical signs of subcutaneous emphysema were seen. An initial chest radiograph was negative for subcutaneous emphysema. Nasal continuous positive airway pressure (CPAP) was started to manage the respiratory distress, and subcutaneous emphysema spontaneously developed. Discontinuation of nasal CPAP with close monitoring eventually resolved the subcutaneous emphysema. Recognition of rare complications due to nasal CPAP may provide physicians with more insight to intervene and provide patients with proper care.