OBJECTIVES: We aimed to report a case with a history of therapy-resistant focal and segmental glomerulosclerosis presenting with the main complaint of severe umbilical pain. A 36-year-old male patient with ascites secondary to nephrotic syndrome applied to emergency service with severe abdominal pain. Decompression of ascites achieved medically by fluid and salt restriction and diuretic administration had led to umbilical hernia incarceration in this patient. The content of the hernia was reducted. With this case, we alarm the clinician for searching presence of umbilical hernia in the medical management of ascites and thinking of incarcerated umbilical hernia for abdominal pain in patients with nephrotic syndrome.