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Giant bullous emhysema is characterized by apically located bullae involving at least 1/3 of one or both lungs. It is most common among young male smokers. Patients are usually admitted to the hospital with acute respiratory failure. Excessively enlarged bulla mistaken for tension pneumothorax during radiologic evaluation. A 37-year-old female patient with no history of smoking presented with cough and wheezing but no dyspnea. Bullectomy was performed with thoracotomy after computed tomography of the chest revealed a giant bulla in the left upper lobe, which displaced the mediastinum to right. The patient was discharged five days after admission. [ABSTRACT FROM AUTHOR]