Introduction: Laparoscopy is the standard of care for the management of dermoid cyst. Even though asymptomatic and diagnosed on routine ultrasonogram (USG) in the majority of the times, surgical removal of dermoid cyst is often mandatory due to its complications such as torsion or rupture. During laparoscopy, an intraoperative spillage is an unpleasant event, not because the contents make the surgery messier and but also because of rare complications such as chemical peritonitis and recurrence associated with it. Case Report: We present a rare case of rampant recurrence of a dermoid cyst after laparoscopic salphingo-ovariotomy within 4 weeks of primary surgery, which had intraoperative spillage during laparoscopy and the catastrophic presentation of it because of widespread peritoneal disease. The tiny foci of immature neuroepithelial cells that got missed after the primary surgery also led to the morbidity. However, early intervention and multidisciplinary management adhering to treatment protocols helped in successful outcome of such catastrophic event. Conclusion: Laparoscopic approach is the gold standard management for dermoid cyst. However, avoiding surgical spillage is the key to minimize the complications. Thorough examination of different sections of dermoid under microscopy is equally important because spillage associated with missing malignant foci on histopathological examination leads to peritoneal disease. [ABSTRACT FROM AUTHOR]