A 67-year-old woman presents with two episodes of impaired consciousness during flights while in Europe. Both happened shortly after ascent. Her symptoms quickly resolved after an emergent landing on her first trip. During the second trip, however, symptoms recurred, and she remained unconscious. She was evaluated at a local hospital where a head computed tomography (CT) showed multiple cortical air locules, predominantly in the right hemisphere, consistent with cerebral air embolism. CT chest revealed a large left bulla with surrounding neovascularization, likely the cause of the embolism. A magnetic resonance imaging (MRI) brain confirmed numerous subacute infarcts across multiple vascular territories and diffuse white matter signal abnormality, consistent with the sequela of cerebral air embolism. She was transported to the US by sea for further management at a tertiary hospital, where she had successful resection of left lung bulla. She was subsequently discharged home with very mild left ataxia.