Abstract: This report is the result of a teamwork of the Unità Operativa di Medicina Iperbarica (Op. Unit of Hyp. Med.) and of the Unità Operativa di Anestesia e Rianimazione (Intensive Care Unit) of the S. Paolo Hospital (Bari, Italy). Purpose of this work is to make a close examination of the literature about cervico-mediastinal gangrene and to illustrate the management in emergency of a septic complication from a tonsillar abscess: the cervico mediastinal gangrene also called descending necrotizing mediastinitis (D.N.M.) (case report).