Renal cell carcinoma (RCC) occupies one of the leading places in the world in the incidence of genitourinary malignancies. According to different authors, the incidence of bilateral RCC is 2—6% among the general RCC population. Surgery is now the only effective treatment for bilateral RCC. Patients with bilateral RCC are at high risk for local recurrence or progression of the disease after organ-sparing surgery; therefore a surgeon has to choose between the high risk of renal failure or recurrence and/or progression depending on the extent of the surgery. According to the literature, patients with bilateral RCC are noted to have an increase in the detection rate of papillary RCC up to 19% and have multifocal lesions. Surgery for bilateral RCC is the only effective method to achieve satisfactory oncological results with a low incidence of complications. The most justified treatment option for bilateral RCC is bilateral organ-sparing surgery that can achieve optimal functional results. The paper describes a clinical case of successful surgical treatment for patients with multiple primary bilateral RCC.