Tuberculosis Peritonitis is a serious condition, whose diagnosis is established late due to the nonspecific nature of the clinical features, which delays the performance of imaging investigations and, implicitly, the setting of the diagnosis through biopsy and histopathological examination. We report the case of a 49-year-old man who presented in our clinic with nonspecific symptoms and significant nitrogen retention, with ascites fluid detected during the clinical–paraclinical examination, ultimately confirming the diagnosis of bacillary peritonitis. Confirmation of tuberculous etiology through biopsy and/or bacteriological examination is sovereign for the diagnosis. The therapeutic protocol includes three anti-tuberculostatic drugs, for a period of at least 6 months, with or without the combination of corticosteroid therapy during the first months of treatment. The patient evolution under treatment was initially favorable, but due to peritoneal adhesions, it underwent complications later.