Meigs' syndrome is a rare condition characterized by the presence of a benign fibroma of the ovary, ascites and pleural effusion. It very uncommon and diagnosis is made difficult by symptoms that usually mimic disseminated malignancy. The gold standard treatment is laparotomy and, by definition of the syndrome, after tumor removal, the symptoms resolves and the patients become asymptomatic. We presented a giant ovarian fibroma with associated Meigs syndrome, successfully managed in a low resources setting.