NPPE (negative pressure pulmonary edema is a rare complication which occurs as a complication of acute or chronic obstruction of upper airway. It occurs during induction or emergence and is seen in normal healthy patient without any cardiac or pulmonary disease. NPPE is caused by significant fluid shift resulting from changes in intrathoracic pressure Negative intra thoracic pressure is generated when patient attempts to inspire against a closed glottis or obstructed airways which leads to increase in venous return and consequent rise in pulmonary venous pressure ,The onset of NPPE is usually rapid and without prompt recognition and treatment outcome can be fatal, We report a case of 10 year old male patient who underwent closed reduction of fracture nasal bone. Patient was given full general anesthesia with injection propofol + scoline and maintained on oxygen + nitrous oxide + sevoflurane and injection vecuronium bromide as muscle relaxant. Postoperatively the throat pack was removed and external POP cast was applied to the nasal cavity by the surgeon. Patient was then reversed with injection neostigmine and glycolpyrrolate on return of spontaneous respiration and then extubated after thorough suction of oral cavity. Immediately on extubation patient developed NPPE which was successfully managed with 100% oxygen, injection lasix, steroids and nebulization.