Peritoneal mesothelioma is a rare diagnosis most often seen in middle-aged men and exceedingly rarely in individuals in their teens and twenties. Diagnosis is often delayed secondary to nonspecific presenting symptoms and a misconception that there must be a history of asbestos exposure to garner such a diagnosis. Here, we present the case of a 21 year-old female with a histologically confirmed diagnosis of peritoneal mesothelioma and review the key radiologic and histologic findings of this rare diagnosis