Intravascular air embolism is a condition in which air enters the intravascular space that leads to obstruction of blood flow resulting in hemodynamic compromise and tissue perfusion deficits. Air emboli can be iatrogenic as the result of medical and surgical procedures (central line placement, angiography, or neurosurgery). Additionally, nitrogenous gas emboli can result during decompression in deep-sea divers. The clinical manifestations are broad and dependent on the location of the embolus in either the venous or arterial circulation and potentially involved end organs. Most common symptoms may be a pulmonary embolism (hypoxia, tachycardia, hypercapnia, hypotension) or neurologic (confusion, seizures, unconsciousness). Diagnosis hinges on patients’ history and the temporal relationship between the onset of symptoms and a risk factor (e.g., procedure). Imaging techniques, including plain film radiographs and echocardiography, when expedient, may aid in diagnosis. Management involves limiting further endovascular intake of air, utilizing positioning to minimize transit of the embolus to the pulmonary arterial or systemic arterial circulation (left lateral decubitus and Trendelenburg position). Supplemental oxygen and even hyperbaric oxygen may expedite resorption of systemic air. Additionally, aspiration of large air pockets in the right atrium or ventricle may be attempted. Failure to recognize onset and progression of air embolism can lead to hemodynamic compromise, neurologic dysfunction, and death.