Background: Meconium peritonitis is a non-bacterial, chemical inflammation of the peritoneum caused by antenatal or postnatal perforation of intestine by meconium. Surgery is necessary when signs of intestinal obstruction are present. Case Report: A 4 day old infant presented with abdominal distension with respiratory distress soon after birth without signs of intestinal obstruction. A high index of suspicion of surgery can potentially prevent errors and complications which may occur during management of these infants. Conclusion: The baby had an uneventful postnatal period and was managed conservatively which has been rarely reported before. Infant is doing well at follow up at 40 days of life.