Generally, viral hepatitis does not lead to ascites, but if viral hepatitis progresses to liver failure, severe hepatitis, or cirrhosis, ascites can occur. The main causes of ascites are related to portal hypertension and sodium and water retention. Additionally, patients with chronic liver diseases often have low albumin levels, leading to hypoalbuminemia, which can also contribute to the development of ascites. Therefore, the presence of ascites in viral hepatitis generally indicates a severe condition, and the outcome after treatment might be poor as ascites can recur. If ascites occurs in viral hepatitis, it is crucial to rule out the presence of cirrhosis. For some patients in the decompensated stage of cirrhosis, the initial symptom might be ascites. Therefore, prompt diagnosis and treatment are necessary once ascites appears in viral hepatitis, requiring further attention.