Abstract: Malignant ascites（MA）are the cancer associated accumulation of fluids in the peritoneal cavity. Symptoms include abdominal distention，nausea，vomiting，anorexia，dyspnea and limbs oedemas，producing a significant reduction in the patients' quality of life. Currently，none of the different options has been subjected to evidence-based clinical trials and there are no accepted guidelines for the management of MA. The challenge for clinicians is to know how to best manage the symptoms of MA patients for optimal outcomes. The purpose of this article is to discuss critically the medical management of MA.