Meigs syndrome is a rare clinical triad defined by the presence of a benign ovarian tumor, ascites, and a pleural effusion, both of which resolve completely following surgical resection of the tumor. The pathophysiologic mechanism remains incompletely understood; however, the leading hypothesis suggests that fluid secretion from the ovarian tumor accumulates in the peritoneal cavity, subsequently migrating through diaphragmatic lymphatic channels into the pleural space. A definitive diagnosis of Meigs syndrome requires the simultaneous presence of all three components: benign ovarian tumor, ascites, and pleural effusion, along with documented resolution of both effusions after complete tumor excision. The pleural fluid is typically exudative, although up to 20% of cases may demonstrate hemorrhagic characteristics. Resolution of the pleural effusion occurs following surgical removal of the adnexal mass; conversely, isolated drainage of the effusion without tumor resection frequently results in reaccumulation. The prognosis after complete tumor excision is excellent, comparable to that of the general population, with no adverse impact on long-term survival.