Meigs’ syndrome is a rare triad of a benign ovarian fibroma (or fibroma‑like tumor), ascites, and pleural effusion that resolves after tumor resection. A 53‑year‑old multiparous woman presented with progressive exertional dyspnea and right‑sided pleuritic chest pain. Respiratory and cardiac evaluations were initially unrevealing. Bedside assessment identified mild right basal dullness, and point‑of‑care abdominal ultrasound demonstrated mild free fluid and a solid right adnexal mass. Chest radiography confirmed a small right pleural effusion. Without computed tomography and without diagnostic paracentesis or thoracentesis, Meigs’ syndrome was suspected. The patient underwent laparotomy with total abdominal hysterectomy and bilateral salpingo‑oophorectomy. Histopathology confirmed an ovarian fibroma. Postoperatively, symptoms resolved dramatically, and follow‑up imaging demonstrated complete resolution of the pleural effusion and ascites. This case highlights the importance of considering gynecologic etiologies in unexplained pleural effusion and dyspnea, especially when accompanied by abdominal distension or pelvic pressure.