Pancake kidney is one of the least common renal fusion anomalies encountered in medical practice. Less than 30 cases of this renal variant have been reported in the medical literature. Patients are generally asymptomatic, with the diagnosis of pancake kidney usually found incidentally on imaging study or autopsy. Given the rarity of reported cases, it is difficult to establish a relationship with specific associated clinical findings. Asymptomatic patients are managed conservatively with regular follow-up. We present the case of a 69-year-old female who was found to have pancake kidney, several renal cysts, and chronic kidney disease (CKD). No other reported cases have the diagnosis of CKD.