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Non-infectious subcutaneous emphysema of the hand has previously been mentioned in literature. In most cases, it presents in a benign and self-resolving form, which may be managed conservatively. However, in cases of subcutaneous emphysema involving insufflation with nitrogen gas, clinical vigilance is advised as acute compartment syndrome may be a potential complication due to the non-permeative nature of the gas. This would necessitate a complete change in the dynamics of management, warranting urgent surgical intervention. Current literature on acute compartment syndrome of the hand complicating subcutaneous emphysema is scarce. This report aims to highlight this unique case and add to the current literature on this rare condition.