Ascites as a main feature of Chlamydia trachomatis infection in two young women was successfully treated with doxycycline. In both patients, ascitic fluid protein levels and lymphocyte counts were very high. This report, as well as six previously published cases, suggest that ascitic fluid culture for C. trachomatis and blood antibody determinations should be performed in all cases of protein-rich lymphocytic ascites in sexually active women.