Anterior cervical discectomy and fusion (ACDF) may lead to complications such as dysphagia, hoarseness, recurrent laryngeal nerve palsy, vocal cord palsy, dural tears with leakage of cerebrospinal fluid, haematoma, and oesophageal and vascular injuries. Hypopharyngeal injury in the early postoperative period is a rare, but life-threatening, problem. We present a patient with dyspnoea who developed subcutaneous emphysema in the early postoperative period after an iatrogenic hypopharyngeal injury following ACDF. These complications prolonged the postoperative course of the patient. The role of careful surgical intervention, and anticipation of potential complications, has been emphasized, especially when surgical exposure of the anterior spinal canal above C(4) is required.