We report a case of pneumomediastinum, subcutaneous emphysema, and mild pneumothorax that occurred after endotracheal intubation with a metallic endotracheal tube for the laser operation. Fortunately, pneumomediastinum and subcutaneous emphysema were self-limited. But potentially life-threatening events such as upper airway obstruction, tension pneumothorax, pneumopericardium, mediastinitis might be possible. These complications may result from mucosal perforation of upper airway. The use of a tube with rigid and relatively narrower internal diameter than polyvinylchloride endotracheal tube, tough endotracheal intubation technique, high peak inspiratory pressure, suction technique and negative pressure are included as complication factors.