We report an extremely rare case of pseudo-Meigs' syndrome caused by ovarian metastases from colon cancer, and review the literature on this unusual entity. A 41-year-old woman was admitted for investigation of abdominal fullness and dyspnea. Preoperative examinations revealed a huge pelvic tumor, adenocarcinoma of the sigmoid colon, marked ascites, and bilateral pleural effusion. Laparotomy confirmed that the huge mass was comprised of bilateral ovarian tumors. Resection of the sigmoid colon and bilateral oophorectomies were performed. Although short-term intrathoracic drainage was required, the hydrothorax and ascites rapidly resolved in the postoperative period. The patient died of disseminated liver and bone metastases 8 months after her operation; however, ascites and hydrothorax were not clinically noted until death. This and five other reported cases demonstrate that ovarian metastasis from colorectal cancer may occasionally cause pseudo-Meigs' syndrome, and that resection of the ovarian lesions could improve the prognosis.