Intracranial complications of acute sinusitis in children are uncommon but may lead to serious neurological impairment. These intracranial complications include pneumocephalus, cerebral abscess, empyema, meningitis, cellulitis, orbital abscess and cavernous sinus thrombosis. Pneumocephalus is defined as the presence of air within the intracranial compartments and may occur in association with neoplasms, infections, surgery, or trauma, as the most common causes. The paper reports a case of a 10-year-old girl with acute onset of pneumocephalus as a rare complication of pansinusitis. She presented to the Paediatric Emergency Unit (EU) with fever, headache and frontal swelling. During the observation at the EU, she presented with vomiting, progressive loss of consciousness and seizures. Pneumocephalus was then detected at brain Computed Tomography promptly performed.