Background: Xanthogranulomatous pyelonephritis (XGP) is an uncommon infectious disease of the kidney known to mimic other renal maladies. A rare presentation of this uncommon disease is spontaneous renal hemorrhage (SRH).
Case Presentation: We report a case of XGP in a 58 year old woman who presented with abdominal pain, hematuria, and radiating left flank pain.