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Background-Schistosomiasis is a trematode infestation causing achronic granulomatous disease in various organs. Both S. mansoni& S. haematobium are endemic in Ethiopia. Most infectedindividuals are asymptomatic. Ectopic schistosomiasis can affectthe lungs, genitalia, CNS, skin, peritoneum, Lymph nodes & otherorgans. Schistosomiasis as a cause of acute abdomen is seldomreported.Case Detail-A 51years -old male Ethiopian farmer presented with atwo weeks history of abdominal pain with recent onset biliousvomiting and abdominal distention. Emergency laparotomy done &the finding was multiple tiny whitish nodule over the peritoneum &small bowel with multiple mesenteric lymphadenopathy. Thediagnosis was confirmed with histopathology study.Conclusions- Schistosomal peritonitis is a very uncommon form ofschistosomiasis. Physicians should be aware of such atypicalpresentation in patients from endemic areas of schistosomiasis.And biopsy should be considered in unsettled forms of peritonitisduring laparotomy. The pathogenesis is not well known whichwarrants further study.