A 28– year old Primi in 13 weeks of gestation presented to the Medical Gastroenterology department with complaints of progressive abdominal distension with loss of appetite for 1month duration. Clinical and Ultra– sonological examination revealed free fluid in the peritoneal cavity with intra uterine gestation, corresponding to the gestational age. Investigations revealed hypo albuminemia. Ascitic fluid analysis revealed low SAAG (0.1 g/dl) with high ascitic protein (6.4 g/ dl). Polymerase Chain Reaction (PCR) of ascitic fluid for AFB– DNA was negative. Ascitic fluid ADA was elevated (116mg/dl). In view of low SAAG ascites with high protein content and elevated ADA levels, diagnosis of abdominal tuberculosis (ascites) was made and patient was started on weight based first line Anti tubercular (ATT) medications. Repeat Ultrasound after completing intensive phase of ATT revealed complete resolution of the ascites. High index of clinical suspicion is necessary for early detection of abdominal tuberculosis in pregnant women