A 46-year-old healthy man presented with abdominal pain and a solitary ectopic, crossed pelvic kidney with an enhancing mass, imaged with 3-dimensional computed tomography. He underwent open partial nephrectomy, which revealed Stage T1, grade 2 conventional renal cell carcinoma with negative surgical margins. The incidence of renal cell carcinoma in the computed tomography era in a solitary crossed ectopic kidney is approximately 1 in 22 million.