A 49-year-old female presented in a casualty department with acute abdomen. The CT scan revealed an extensive build-up of peritoneal and retroperitoneal fluid. Laparotomy revealed chylous ascites in the abdominal cavity. The patient made a successful recovery following treatment with total parenteral nutrition. No cause of the chylous ascites was found. Extensive diagnostics are indicated in adults with chylous ascites without a history of surgery as the most common cause of the condition in this group is malignant lymphoma. Treatment is targeted at a good nutritional status, lowering chylous production and treating the underlying causes.