Meigs syndrome, characterised by a pelvic mass, ascites and pleural effusion, is commonly associated with benign ovarian fibromas. It can mimic ovarian carcinoma both clinically and radiologically, leading to potential misdiagnosis. Early recognition of Meigs syndrome is crucial to prevent unnecessary interventions, such as chemotherapy or extensive surgery. This is a case summary of a woman in her early 50s who presented with abdominal pain, shortness of breath and a pelvic mass, suggestive of ovarian malignancy. Imaging and elevated CA-125 levels raised suspicion for ovarian cancer. However, histopathological examination of the mass revealed an ovarian fibroma, confirming Meigs syndrome. Meigs syndrome should be considered as part of the differential diagnosis in cases of pelvic masses with ascites and pleural effusion, helping to guide appropriate management and avoid unnecessary treatments.