In medicine, Meigs' syndrome is the triad of ascites, pleural effusion, and benign ovarian tumor (fibroma, Brenner tumour, and occasionally granulosa cell tumour). It resolves after the resection of the tumor. Because the transdiaphragmatic lymphatic channels are larger in diameter on the right, the pleural effusion is classically on the right side. The etiologies of the ascites and pleural effusion are poorly understood. Atypical Meigs' syndrome,characterized by a benign pelvic mass with right-sided pleural effusion but without ascites, can also occur. As in Meigs syndrome, pleural effusion resolves after removal of the pelvic mass. The authors would like to share their own experience of a case of Meigs' syndrome associated with an enormous ovarian fibroma and elevated Ca-125.