We report the case of a 68 year-old woman who underwent surgical treatment for xanthogranulomatous pyelonephritis. Xanthogranulomatous pyelonephritis is a rare, chronic, inflammatory lesion of the kidney. It is most frequently seen in middle-aged women. Because of its clinical and radiological similarities to other renal lesions it can be difficult to establish a preoperative diagnosis. Nephrectomy is needed in most patients.