A 31-year-old primigravida woman (22 weeks' pregnant) presented at our Maternity Department complaining of abdominal pain, nausea and vomiting. These symptoms appeared 6 months ago. Initially, they were attributed to pregnancy, but they progressively became more severe during subsequent weeks. A clinical examination revealed a cachectic conscious anicteric woman with mild fever (38 C). The cardiovascular and pleuropulmonary examination were normal. Her abdomen was distended, deep tenderness was elicited in both iliac fossae, and a fluid thrill with shifting dullness confirmed the presence of intraperitoneal free fluid. An abdominal ultrasound confirmed the pregnancy and showed intra-abdominal fluid, mainly in her lower abdomen and a thickened peritoneum (Figure 1). No ovarian mass was identified on ultrasound. A laboratory investigation showed mild normochromic and normocytic anemia (hemoglobin level 10g/dL) and high C-reactive protein without leucocytosis. Her liver function was normal. Serology of viral hepatitis (B and C) and human immunodeficiency virus (HIV) were negative. Of tumor markers, only cancer antigen 125 (CA-125) was found to be high (500U/mL). Ascitic fluid was exudative with a white cell count of 860/mm3 (lymphocyte dominant: 480/mm3). Her serum-ascites albumin gradient was calculated to be 0.9. Ziehl-Neelsen stain which was investigated in three samples of sputum and in ascitic fluid was negative. The result of a tuberculin skin test was positive. The chest X-ray picture showed no active lesion or old lesion compatible with pulmonary tuberculosis. A diagnostic laparoscopy showed multiple extensive yellow-white nodules on her peritoneal surface with miliary deposits on the intestine (Figure 2), and the biopsy demonstrated caseous necrotic granuloma (Figure 3). She was prescribed antituberculous chemotherapy with rifampicin, isoniazid, and pyrazinamide for 2 months and 4 months of rifampicin-isoniazid. She was given pyridoxine supplementation (25mg/day). After 4 days her general condition improved significantly and her pregnancy continued without any problem. At term a spontaneous vaginal delivery occurred of a live healthy male neonate weighing 3100g. Treatment was well tolerated during pregnancy and after delivery we saw no adverse effects of antituberculosis therapy in either the mother or the neonate.