Meigs’ syndrome represents a triad of pleural effusion, ascites, and an ovarian tumor, which is usually benign, occurring together. We describe here 2 patients with Meigs’ syndrome and 2 patients with pseudo-Meigs’ syndrome. Hydrothorax and ascites symptoms in 4 patients are of outstanding performance characteristics of Meigs’ syndrome and pseudo-Meigs’ syndrome. Ovarian tumors were found by clinical examination and surgically removed. Postoperatively, these signs of hydrothorax and ascites were dissolved completely. Conclusions: These cases highlight the difficulties that may be encountered in the management of patients with Meigs’ syndrome, including potential misdiagnosis of the tumor as a malignant ovarian neoplasm that may influence the medical and surgical approach, and the adverse impact that Meigs’ syndrome can have on the patient’s condition. Clinical doctors should be alert to this kind of disease under pathological diagnosis in the absence of a clear effect of chemotherapy or radiotherapy and to prevent unnecessary harm to the patient.