Chylous ascites is the accumulation of peritoneal fluid rich in triglycerides in the peritoneal cavity. It commonly develops when there is disruption of the lymphatic system due to traumatic injury or obstruction. Chylous ascites is diagnosed when ascetic fluid appears milky and contains a triglyceride content above 200 mg/dl. Patients identified as suffering with chylous ascites are treated to correct the specific underlying cause. Therapeutic paracentesis and administration of diuretics are recommended for patients with underlying cirrhosis. Appropriate nutritional support for chylous ascites, including a low-fat diet and medium-chain triglyceride supplementation, is of paramount importance. (SMN 2011;2:39-40)