Primary peritoneal adenocarcinoma is a relatively newly identified disease entity whose clinical behavior is not fully recognized. We report a case of a patient with progressive primary peritoneal adenocarcinoma who developed brain metastases and died shortly afterward. The incidence of central nervous system metastases in 72 patients with documented primary peritoneal adenocarcinoma was 1.4%. The risk factors, clinical behavior, and prognosis of patients with primary peritoneal adenocarcinoma metastatic to the central nervous system seem to be similar to those of patients with epithelial ovarian cancer metastatic to the central nervous system.