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Percutaneous transthoracic needle biopsy is an indispensable tool that allows the minimally invasive characterization of pulmonary nodules, masses, and inflammatory disease. Systemic air embolism is a very rare complication resulting from percutaneous transthoracic needle biopsy and can be catastrophic. Knowledge of this entity may minimize morbidity and mortality after percutaneous transthoracic needle biopsy. In contrast to the majority of published reports, we report an asymptomatic patient with systemic air embolism after percutaneous transthoracic needle biopsy and emphasize the significance of this rare complication, as hospital code teams may be unfamiliar with this complication. We also review imaging findings and management options for this rare entity.