SummaryFour cases of subcutaneous emphysema of gastrointestinal origin are presented, with a review of literature. The possible mechanism of diffusion of air through different anatomic routes, together with the role of infection, is described. Subcutaneous emphysema as an important diagnostic sign in cases of gastrointestinal perforation and intra‐abdominal or retroperitoneal abscess is emphasized. Treatment should be directed to the primary disease, disregarding the extent of emphysema. Surgical emphysema and pneumomediastinum usually sema and pneumomediastinum usually subside within two weeks after treatment of the primary disease.