We present a case of bilateral pneumothorax (PNX) and pneumo-mediastinum that developed after manual ventilation with a bag valve device during transport. A 65-year-old female patient underwent a lumbar disc stabilization surgery under general anesthesia. Manual ventilation with a bag valve device was performed during transport to imaging center. However, the patient developed bilateral pneumothorax and pneumo-mediastinum. The chest tube was inserted, and the patient made a rapid recovery. The chest tube was removed on the third postoperative day, and she was discharged uneventfully on the sixth
postoperative day.