Peritoneal tuberculosis is still common in Morocco. Its diagnosis is based on several methods. Laparosco- py with directed biopsies is still considered as the ref- erenced method. The aim of our work is to show the place and the importance of laparoscopy in the diag- nosis of peritoneal tuberculosis through the study of various endoscopic aspects. Materials and Methods: This is a retrospective descriptive study extended from January 2001 to December 2011. We collected 414 cases of isolated ascites confirmed by ultrasono- graphy. Different parameters were analyzed: epidemi- ological data, indications of laparoscopy and its re- sults and complications. Results: The average age of our patients was 38 years (range: 8 years – 90 years) with a female predominance (sex ratio F/M: 2.3). Abdominal ultrasound performed in all patients has confirmed the presence of ascites in 100% of cases. Based on clinical data (soft or tense abdomen) and ul- trasound (free or partitioned ascites), we performed a standard laparoscopy in 313 cases and open laparo- scopy in 101 cases. The presence of granules was no- ted in 318 cases (76.8%). Peritoneal tuberculosis was found in 81.5% of cases with small whitish granula- tions distributed homogeneously, while peritoneal car- cinomatosis was confirmed in 86.8% of patients with large granules distributed inhomogeneously. The pre- sence of adhesions was observed in 33% of cases with peritoneal tuberculosis, while it was mentioned in only 2.8 cases of carcinomatosis. Conclusion: Despite the development of imaging means, ascitic fluid culture and PCR (polymerase chain reaction), laparoscopy remains indispensable for an early diagnosis of peri- toneal tuberculosis and adequate management