A 42-year-old male who had undergone the total nephroureterectomy for transitional cell carcinoma (Grade 3) in the left renal pelvis 5 years ago was seen with asymptomatic macroscopic hematuria. An evaluation of the clinical investigations revealed the right renal pelvic tumor. The right nephroureterectomy was performed and histological examination showed transitional cell carcinoma (Grade 2) of the renal pelvis. Postoperatively, the patient has been treated with intermittent maintenance hemodialysis. He is well and has no evidence of recurrence or metastasis 10 months after the surgery. The previous reports of bilateral renal pelvic tumors (28 cases) are reviewed and the incidence, age, interval between the first and second tumors, prognosis and management including postoperative hemodialysis are discussed.