Serositis is seen in approximately 12% of patients with systemic lupus erythematosus (SLE), usually in the form of pleuritis or pericarditis. Peritoneal serositis with ascites is an extremely rare manifestation of SLE and ascites as initial manifestation of SLE is even rarer. Here, we describe a previously healthy 48-year-old female with periumbilical abdominal pain, constitutional symptoms, ascites, pleural effusions and raised CA-125 level as an initial manifestation of SLE, which led up to the diagnosis of pseudo-pseudo Meigs syndrome. PPMS is a rare manifestation of SLE and awareness of this entity among clinicians is crucial to ensure an early recognition and prompt treatment.