A 35-year-old female with chronic pain believed to arise from a nodule on the right shoulder presented to an acupuncturist on the day of admission seeking relief from this pain. Two acupuncture needles were introduced into the areas marked with “X” on the patient in Figure 1 with resulting severe pleuritic pain once the needles were retracted. The patient continued to have severe pain and presented herself to the Emergency Department for further evaluation. A Chest X ray revealed an apical pneumothorax shown in Figure 2 and 3.