A 21-year-old US member was in Panglao, Philippines, free diving to approximately 100 feet/30 meters. She reported crackling sounds in her left ear and tenderness near her left temple. She was initially managed with first-aid advice and evaluated in person by a nurse. As symptoms persisted, she was transported to a medical center where she was assessed by an ear, nose and throat specialist and prescribed oral antibiotics. Ongoing concern for pressure-related injury led to further evaluation at another medical center, where she was diagnosed with decompression sickness type 1 and treated with daily hyperbaric oxygen therapy for three days. Following treatment, she was cleared to fly and completed onward travel without complications. She was advised to arrange follow-up care after returning home.