Majority of ovarian cancer (OC) patients are usually diagnosed at advanced stage and present with peritoneal spread/ascites. Some patients develop pleural deposits/effusion secondary to transdiaphragmatic spread of peritoneal disease/ascites. However, pleural deposits/effusion from OC in the absence of peritoneal disease/ascites are very rare. We present a case of serous carcinoma of the left ovary with fluorodeoxyglucose (FDG) avid right pleural deposits and effusion in the absence of peritoneal disease/ascites on FDG positron emission tomography (PET)/computed tomography (CT), showing excellent response to chemotherapy in subsequent PET/CT. We also discuss the pathophysiology of pleural abnormalities in patients with ovarian diseases, a characteristic disease spread pattern and recognition of which would help in the imaging interpretation.