Management of refractory ascites (RA) can be accomplished in many ways. Rapid recurrence will be a problem even with repeated paracentesis. We studied the use of a permanent Tenckhoff catheter (PTC) for drainage of RA in 10 patients. The cause of RA was cardiomyopathy in 7 patients, malignancy with liver metastasis in 2, and end-stage liver disease in 1 patient. The volume of ascites drained (AD) ranged from 0.5-7.0 L, with a mean of 2.6 L. Mean blood pressure pre-AD was 112/68 mm Hg, and post-AD was 109/66 mm Hg (p > 0.05). Heart rate pre- and post-AD was 80 bpm and 81 bpm, respectively (p > 0.05). The number of ADs ranged from two to 63 (mean: 16). There was no fluid replacement during or post-AD. There were no complications or infections from AD. The mean interval between ADs was 7.8 days. Mean duration of survival was six months. All patients eventually expired. In conclusion, PTC can be a useful and safe alternative for draining RA at home in terminally ill patients. Complications of repeated paracentesis are minimized, and the need for hospitalization is avoided. AD with PTC may be preferred to repeated paracentesis in RA.