A young case diagnosed with peritoneal tuberculosis with ascites will be presented here. Conditions that may pose a significant risk for the development of tuberculous peritonitis; poor hygiene, overpopulation, consumption of unpasteurized milk, cirrhosis, peritoneal dialysis, HIV infection, drug abuse and inadequate access to healthcare. In general, the tuberculosis agent reaches the gastrointestinal system via hematogenous route, ingestion of infected sputum, or direct spread. Peritoneal TB should be considered in the differential diagnosis in patients with abdominal pain, diarrhea, weight loss, anorexia, night sweats, presence of ascitic fluid, bilateral pleural effusion, pleural nodule appearance, and findings suggestive of peritonitis carcinomatosis, as in our case. Peritoneal tuberculosis is rarely diagnosed, without a high index of suspicion for this disease.