: Necrotizing pneumonia (NP) is a rare complication of community-acquired pneumonia, which occurs in patients with viral pneumonia such as influenza and secondary bacterial infection. We present a five-year-old boy with cough and dyspnea and low SpO2, who was admitted to PICU. He was intubated, and two-sided chest tubes were placed because of pleural effusion. Nasopharyngeal RT-PCR for H1N1 was positive. Subcutaneous and mediastinal emphysema and a large pneumatocele developed concomitantly, and the patient underwent three times percutaneous aspiration of pneumatocele under anesthesia and CT scan guide without surgery. The size of the pneumatocele decreased, and the patient was extubated. After one month of admission, he was discharged in good condition and no pulmonary sequela.