Ascites is the accumulation of free fluid in the peritoneal cavity. Ascites is one of the most common complaint amongst the various clinical problems confronting a physician, and ascitic fluid analysis is the most effective way of etiological diagnosis. Traditional classification into ‘exudative’ and ‘transudative’ depending on the Serum Ascites Albumin Gradient (SAAG) is unable to correctly identify the conditions. Hence a more reliable method to classify the same is required. Early diagnosis of Tuberculosis Peritonitis is often difficult to make as symptoms of Tuberculosis Peritonitis is generally non-specific. The study was conducted on patients with ascites admitted to the Medicine and Gastroenterology Department,. Totally 124 patients were included in the study of which, 98 patients had Cirrhotic Ascites, 12 patients had Tubercular Ascites, 14 patients had Malignant Ascites. Clinical evaluation, abdominal ultrasonography, and laboratory investigations were conducted as follows: Serum lipid profile, Ascitic Lipid Profile and SALG of total cholesterol, triglyceride, HDL cholesterol, and LDL cholesterol. On analysis, it was found that the SALG values are significantly higher in cirrhosis than tuberculosis or malignancy. A close relationship between the levels of SALG and type of Ascites was found which was significant for differential diagnosis.