A 27-year-old medical student seeking acupuncture therapy for a right levator scapular muscle spasm developed acute dyspnea, chest pain, and nonproductive cough within minutes following the treatment. The patient was later diagnosed with a 30% pneumothorax of the right lung. Pneumothorax is a well-known adverse effect of medical procedures such as central line placement, thoracocentesis and transbronchial lung biopsy. This case illustrates another iatrogenic cause of pneumothorax--acupuncture-induced pneumothorax. A review of the literature since 1985 reveals nine case reports of acupuncture-induced pneumothorax.