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Ovarian hyperstimulation syndrome (OHSS) is a rare syndrome, characterized by cystic enlargement of the ovaries and a fluid shift from the intravascular to the third space due to ovarian neo-angiogenesis and increased capillary permeability. It is generally iatrogenic, occurring due to administration of human chorionic gonadotrophin (hCG) during assisted reproductive techniques. Spontaneous form of OHSS is so rare that is easy to confuse the diagnosis of spontaneous OHSS with other causes. Here we present a case of spontaneous OHSS in a 30-year-old Indian female who was 5 weeks pregnant. Since there was no history of hormone stimulation before/during this pregnancy, ovarian carcinoma instead of OHSS was thought to be the primary diagnosis. A battery of tests and investigations, the diagnosis of moderate OHSS was made after excluding all other causes. The patient was managed conservatively and her symptoms improved with time. If the diagnosis is missed, there may be risk of unnecessary interventions and morbidity in such patients. Strict monitoring of patient in hospital is required. In most cases of mild to moderate OHSS only conservative management is needed while in severe cases, intensive care unit (ICU) admission may be necessary.