Primary peritoneal serous borderline tumors (PPSBT) are epithelial proliferations with low malignant potential, but they are rare entities. Due to their rarity, PPSBTs are often misdiagnosed as undiagnosed diffuse primary ovarian carcinomas. This leads to unnecessary and more aggressive treatments. Tough, accurate recognition of PPSBT is crucial in clinical practice. This narrative review examines the current literature to provide practical guidance on the diagnosis and management of PPSBT. A key methodological choice in this review is the inclusion of a clinical case, which serves to contextualize the literature evidence in a real-world scenario. The case involves a 51-year-old asymptomatic woman who underwent laparoscopic excision and staging of a 99x51 mm mass, later confirmed as a PPSBT staged IA sec FIGO. The patient's recovery was uneventful, and she remains disease-free after two years. This case, one of the few laparoscopically treated examples in the literature, underscores the value of minimally invasive surgery for both excision and staging and reinforces the importance of accurate diagnosis in improving clinical outcomes for PPSBT.