Abdominal tuberculosis is defined as infection of the gastrointestinal tract, peritoneum, abdominal solid organs, and/or abdominal lymphatics with Mycobacterium tuberculosis. It constitutes approximately 12% of extrapulmonary TB cases and 1 to 3% of total TB cases.Approximately 15%-25% of cases with abdominal TB have concomitant pulmonary TB. However association of unilateral transudative pleural effusion with TB abdomen is rare.A 45 years female with no significant past history presented to us with chief complaints of progressive e dyspnea, distension of abdomen, low grade fever, loss of appetite for past 2 months. On examination her vitals were stable apart from a respiratory rate of 24/min and had diminished breath sound over right hemithorax. Per abdominal examination was unremarkable. Chest X-ray showed right massive pleural effusion. USG & CECT of abdomen& pelvis revealed circumferential wall thickening involving ileo-caecal junction & part of ascending colon with mesenteric lymphadenopathy. Colonoscopy guided biopsy from ascending colon showed granuolomatous inflammation in necrotic background. Biopsy specimen was negative for MTB in CBNAAT. 2300mlclearpleural fluid aspirated from right pleural cavity with fluid cytology being predominantly lymphocytic, ADA 3.1 IU/L, transudative effusion. ECG & 2D ECHO were unremarkable. Pleural fluid and induced sputum were negative for MTB on CBNAAT, as well as culture. Her blood investigations were normal. HRCT thorax showed centrilobular nodule involving bilateral upper lobes with bronchiectatic changes. Bronchoscopy guided BAL fluid & post bronchoscopy sputum were negative for AFB with 30% lymphocytes on differential count. Tuberculin test was positive with an induration of 20mm.Various causes of transudative pleural effusion were excluded. Patient was clinically diagnosed as abdominal tuberculosis and started with ATT and patient improved on subsequent follow up.