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The development of ascites in hyperthyroid patients is a rare phenomenon and usually occurs in the context of exaggeration of right-sided heart failure , so it is categorized as high SAAG ascites. In this case report, we present a 73-year-old man who was referred to us with anorexia, severe weight loss, anemia, lower limbs pitting edema, and also exudative, low SAAG ascites. Extensive work up revealed that these constellation of signs & symptoms were consequent to decompensation of his chronic right-sided heart failure resulting from apathetic hyperthyroidism.