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Subcutaneous emphysema in the head and neck is a rare condition, normally caused by major underlying injury to the airway or gastrointestinal tract. We report a non-traumatic occurrence of spontaneous cervical subcutaneous emphysema in a 30-year-old man who had been snorting mephedrone. The patient made an uneventful recovery, being managed conservatively, and did not require airway support. The occurrence of spontaneous cervical emphysema associated with snorting mephedrone has not been previously described in the literature.