Background: Abdominal lymphadenopathy is a common presentation of many diseases and sarcoidosis should be considered as an important differential diagnosis. Prompt early diagnosis would help to minimize the disease progression and its complications. Case Report: A 51 year old female presented with appetite and weight loss of seven months duration and found to have an intra-abdominal lymphadenopathy. A celiac axis lymph node biopsy showed granulomatous lymphadenitis and the patient quickly progressed to develop hepato-splenomegaly with CT evidence of multiple attenuation areas in spleen, intra-pulmonary nodules with lymphadenopathy. An endo-bronchial biopsy also confirmed a non-necrotizing granulomatous inflammation. Patient had a remarkable improvement in symptoms with oral steroids. Conclusion: Intra-abdominal lymphadenopathy, an initial presentation of many common diseases has heterogeneous etiology and sarcoidosis is one important clinical diagnosis. Appropriate use of available investigations and careful regular clinical assessment with multi-disciplinary approach to identify new organ involvement will help to arrive at early diagnosis and treatment.