Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of aggressive non-Hodgkin lymphomas with a rare occurrence, representing less than 15% of all adult non-Hodgkin lymphomas. The diagnosis and treatment of PTCLs pose significant challenges due to their diverse presentations and the aggressive nature of the disease. This case report discusses a 58-year-old male with a long-standing history of diabetes mellitus and previous bypass surgery, who presented with jaundice, hepatosplenomegaly, and ascites. Laboratory findings showed anemia, elevated liver enzymes, and hyponatremia. Imaging and biopsy results revealed nodular lung lesions, hepatosplenomegaly, liver mass lesions, bile duct dilatation, abdominopelvic lymphadenopathies, and T-cell lymphoma infiltration. The patient's treatment protocol included the CHOEP + BV regimen, alongside interventions for hyperbilirubinemia and renal failure. This case underscores the atypical presentation of PTCL with jaundice and the complexities involved in diagnosing and managing such cases, highlighting the need for a thorough and multidisciplinary approach.