Introduction. - End-stage renal failure patients are particularly at risk for tuberculosis, especially for peritoneal tuberculosis. Microbiological diagnosis remains hazardous in many cases. Case report. - We report on a case of peritonea] tuberculosis in an end-stage renal failure patient. The diagnosis was suspected on the basis of adenosine deaminase dosage in peritonea] fluid, allowing an early presumptive treatment and a favourable outcome with a 3 years follow-up. Discussion. - The measurement of adenosine deaminase activity in ascites represents a diagnostic advance in tuberculous peritonitis among end-stage renal failure patients. (C) 2007 Elsevier Masson SAS. Tous droits reserves.