Over 15 years, 61 cases of tuberculous peritonitis have been diagnosed and managed in the Surgical Department of Cerrahpasa Medical Faculty, Istanbul. The average age of the patients was 35 years. The main clinical features of abdominal pain, weight loss, vomiting and sweating at night had been present in a large number of patients for several months. The clinical diagnosis of tuberculous peritonitis was difficult in the absence of extraperitoneal tuberculosis. Laboratory investigations were of little value in establishing the diagnosis. At laparotomy diagnosis was established by histologic examination of intra-abdominal tissue in all cases. Tuberculosis will not be diagnosed or correctly treated unless it is considered in the differential diagnosis and appropriate specimens sent for bacteriology and histology. Although abdominal laparoscopy has been described as the diagnostic procedure of choice, which is a less invasive method, it is not in routine use in most hospitals of developing countries where tuberculous peritonitis is seen. Therefore laparotomy is a safe and fast method of obtaining tissue for confirmation of the diagnosis in suspected cases, particularly when presenting acutely.