Ascites is the accumulation of abdominal fluid in the peritoneal cavity. Liver cirrhosis, Intraabdominal malignancy, tuberculosis are the major etiologies of ascites. In our context, etiology behind ascites and its correlation with symptoms and its complications are not yet studied, so the present study is conceptualised to evaluate the clinical profile of ascites. The aim of the present study was to observe the prevalence, clinical management and the assessment of complications associated with ascites in hospitalized patients, offering insights into contemporary ascites management and outcomes. It was a prospective Observational Study conducted at a tertiary care hospital of Hyderabad over 6 months studied in 113 patients with ascites. All patients who fulfilled the inclusion criteria of above 18 years and ascites confirmed by clinical and ultrasound examination were thoroughly evaluated with a detailed history, physical examination and appropriate investigations. The predominantly male (83%) patient population exhibited liver cirrhosis (27%) as the primary cause, followed by alcoholic liver disease (23%) and portal hypertension (17%). Abdominal distension (24%) and hepatic encephalopathy (35%) were prevalent symptoms. Laboratory analysis revealed transudative ascitic fluid in most cases (10% with SAAG values >1.1 mg/dl), prevalent hyponatremia (up to 50% in cirrhosis and ascites patients), hyperkalemia (1.6%) and anaemia (7%). Management primarily involved diuretics (23%) and human albumin transfusions (19%). The study highlights early detection and comprehensive management including liver transplantation consideration for eligible patients, as pivotal for improved outcomes and reduced morbidity and mortality. Emphasizing a multidisciplinary approach, this study underscores the necessity of vigilant monitoring, appropriate fluid handling, and collaborative efforts among medical specialties in ascites management