Surgeons should be aware of a very unusual cause of post-cesarean sect
ion peritonitis. This rare form of peritonitis is caused by the spilla
ge of vernix caseosa material into the peritoneal cavity. The exact me
chanism of the development of peritonitis in these few cases is unknow
n,Clinically, vernix caseosa peritonitis should be considered in the p
ost-cesarean section acute abdomen after excluding the more common cau
ses of peritonitis such as appendicitis and perforated viscus. Intraop
eratively, the presence of cheese-like yellow patches limited to the s
erosal layer of visceral organs is the most characteristic feature. Hi
stopathological examination of these serosal patches reveal the desqua
mated anuclear squamous cells confirming the diagnosis. Postoperative
treatment with antibiotics should be continued. The addition of steroi
ds (only after confirming the diagnosis pathologically) has a signific
ant effect on improving the clinical outcome.