Tension pneumothorax is a rare but critical complication of mechanical ventilation. Many researchers regard elevated peak inspiratory pressure as a major etiology for pneumothorax during ventilatory care. Bronchospasm is another adverse events under general anesthesia and it has been reported that the risk of bronchospasm is increased in the children with recent upper respiratory infection. We have experienced a case of recurrent bronchospasm which finally ends up with bilateral tension pneumothorax and debilitating consequences. A 2 year-old boy with a history of croup one week before neuroblastoma excision operation developed several times of bronchospasm attacks during the operation. Episodes of bronchospasm continued in the ICU and complicated with sudden postoperative bilateral tension pneumothorax. Pneumothorax possibly associated with bronchospasm was rarely reported until now. Therefore, we present this case with the literature review.