An 11-year-old female with spastic quadriplegia was seen in the emergency room with abdominal pain, vomiting and anorexia. Labs revealed possible pancreatitis and signs of a urinary tract infection. A CT scan was performed to assess her abdominal pain and demonstrated circumferential air within the bladder wall. Following cultures being drawn, she was started on broad spectrum antibiotics. Her urine eventually grew Klebsiella Pneumoniae. Follow up imaging 2 weeks later demonstrated resolution of the air. Emphysematous cystitis is an exceedingly rare condition in the pediatric population, with this report representing the second case within the literature.