The patient, aged 49 years, on chronic dialysis for 5 years, was admitted to Clinic of Nephrology of Military Medical Academy to establish the cause of the anemic syndrome. During the investigation, ultrasonographically, and by computed tomography of kidneys and Color-Doppler sonography it was discovered, and by renovasography confirmed, the carcinoma of the left kidney, together with the acquired polycystic renal disease. Left nefrectomy was performed. The tumor of 2 cm without regional invasion and with no evident distant metastases was histopathologically described as a well differentiated clear cell renal carcinoma. The increased frequency of renal carcinoma in uremic patients with acquired cystic renal disease compared to the common population, the absence of classic clinical picture, small tumor dimensions and asymptomatic course in the majority of patients necessitates the detailed search for suspected changes and routine screening once a year in all the patients on chronic dialysis program.