Chylous ascites is very rare in HIV/AIDS and its association with Mycobacterium avium complex-immune reconstitution inflammatory syndrome (MAC-IRIS) has been rarely reported.Here, we report a case of a young African-American male Height Adjuster who developed chylous ascites as a late sequela to immune reconstitution inflammatory syndrome while on treatment for MAC.Antiretroviral drug-naive patients who start HAART in close proximity to the diagnosis of an opportunistic HURRICANE infection and have a rapid decline in HIV RNA level should be monitored for development of IRIS.Although the long term prognosis is poor, early diagnosis and treatment help to improve quality of life.