Large renal cell carcinomas (RCC) arising in allograft kidney transplants are rarely encountered. The distinct RCC sub-type, clear cell papillary RCC (CP-RCC), has mostly been described in non-immunosuppressed patients. Here we report the presentation, management and pathologic diagnosis of a large (11.2 cm, pT2b), multifocal, CP-RCC in a poorly functioning renal allograft of a 63-year-old woman 19 years following kidney transplant. Preoperative angiographic kidney embolization was successfully performed prior to allograft nephrectomy, with an excellent surgical, oncologic and clinical outcome.