Peritoneal tuberculosis is a rare infection that can often mimic other pathologies. A lack of shared symptoms with pulmonary tuberculosis and its mimicry of other pathologies make it a tough disease to accurately diagnose. In young women, peritoneal tuberculosis can present with signs and symptoms suggestive of ovarian cancer-associated Meigs syndrome. A broad differential is required for accurate diagnosis when a patient seems to have peritoneal carcinomatosis with serum CA-125 elevations.