A 72‐year‐old woman developed left hemiparesis, and her initial magnetic resonance imaging (MRI) showed multiple acute ischemic lesions. Although she was treated with antithrombotic therapies, follow‐up MRI showed a recurrent small ischemic stroke. Her serum CA125 level was markedly elevated, and abdominal computed tomography (CT) and MRI showed a pelvic mass lesion with pleural effusions and ascites, suggesting malignant ovarian tumor associated with Trousseau's syndrome. However, the surgical resection specimens were pathologically diagnosed as benign ovarian fibroma and serous cystadenoma, and she was finally diagnosed as having Meigs syndrome. This case suggested that Meigs syndrome with elevated CA125 levels might play a role in the development of recurrent ischemic strokes.