A rare case of idiopathic chylous ascites in a young female is reported. The management and outcome with long term follow up were discussed. The variable nature of presentation of chylous ascites necessitates high index of suspicion. Diagnosis predominately requires abdominal paracentesis and triglyceride levels in the ascetic fluid obtained. Management of idiopathic chylous ascites is mostly conservative, once the diagnosis is established. The treatment may include low fat diet and occasional somatostatin use. Further research is mandatory as there is a significant rise in reported cases with no standardized guidelines for management.