Tuberculosis (TB) is the most common infectious cause of human death. After the lung, genitourinary tract is the most common site for TB infection. Pelvic tuberculosis should be considered in young women presented with pelvic mass, ascites, fever, an elevated CA125 level, negative cytology, and positive history of contact with affected person. A 24- year- old girl presented as stage IV ovarian cancer due to pelvic mass, ascites, bilateral multiple lung nodules is described. Further evaluation revealed inflammatory lesion of the left sacroiliac joint. Serum CA 125 was normal. PCR on tissue specimen from sacroiliac joint showed Mycobacterium Tuberculosis. Within two months after anti TB therapy pelvic mass, ascites and lung nodules resolved completely without any surgical intervention.This is the first case of active pelvic tuberculosis with normal CA125 that has been reported up to now.