The development of soft tissue air emphysema after dental treatment is an infrequently reported sequel. It may be caused due to inadvertent introduction of air into soft tissues during procedures using high speed, air driven hand-pieces or air–water syringes. However with scattered case reports and reviews in dental, surgical, anaesthetic and dermatologic literature, it appears to be under reported and rare. Orbital emphysema due to dental treatment is even a rarer entity with very few documented cases in literature. A case of subcutaneous orbital emphysema following routine metal crown removal is presented to illustrate the typical presentation, differential diagnosis, management and prevention of this uncommon condition.