Idiopathic or primary spontaneous pneumothorax (PSP) is the accumulation of air in the pleural space that is not triggered by any trauma or invasive procedure, mechanical ventilation or pulmonary infection. 1 PSP prevalence is estimated between 16 and 52 cases per 100,000 persons, with most cases noted before the age of 23 years, and more particularly in tall and fine male adolescents around 16.3 years. 2 Diagnosis of PSP is usually evident, but the underlying pathophysiology is still hypothetic, and the best management to adopt is clearly not consensual. [2][3][4][5][6][7] Procedures regarding early diagnosis, chest CT-scan indication, therapy, and PSP recurrence prevention are highly variable and centre dependent, particularly in paediatric patients. In adults, guidelines, like that of the British Thoracic Society