Pulmonary interstitial emphysema (PIA) is an air leak syndrome defined as the accumulation of air in the perivascular connective tissue and collection in the interstitium as a result of rupture of the alveolar and small airways. It is frequently seen in the neonatal period, especially in premature babies followed up under mechanical ventilation support. Here, a premature patient who received no invasive mechanical ventilation support and was diagnosed with localized PIA that recovered with conservative treatment is presented.