Chylous ascites is an uncommon complication seen in gynecological malignancies. The incidence of postoperative chylous ascites in gynecological malignancies is 0.17%. It is the extravasation of milky chyle into the peritoneal cavity due to lymphatic obstruction or injury diagnosed by detection of triglyceride levels greater than 200 mg/dl in ascitic fluid. The site of leakage can be determined by lymphangiography or lymphoscintigraphy. Most of the cases of chylous ascites can be treated by conservative methods like a dietary modification to a low-fat high-protein diet, bowel rest, total parenteral nutrition, medications, large-volume paracentesis. If these measures fail, surgical modalities like laparotomy or peritoneovenous shunting are employed.

In our case, the patient was successfully managed on dietary modification alone. This case report emphasizes the importance of conservative management for chylous ascites following surgery and radiotherapy in endometrial carcinoma.