The majority of atraumatic chylous ascites in adults is caused by malignancies. Among the different malignancies, lymphomas are by far the most common causes of chylous ascites. Other reported causes include neoplasms arising from the breast, endometrium, ovary, testis, pancreas, esophagus, stomach, colon, prostate, carcinoid, and lung. However, atraumatic chylous ascites secondary to bladder cancer is extremely rare. We report here the case of a 74-year-old male with stage IV bladder cancer who was found to have chylous ascites.