The renal sinus contains within it the collecting system of the kidney as well as lymphatics, nerves, and renovascular structures. This area may be affected by a large variety of pathological conditions arising from the various tissues in this site. Vascular lesions of the renal sinus are uncommon and may present clinically with acute symptoms and on imaging as a mass lesion. Awareness of the different vascular lesions affecting this area is essential for establishing the correct diagnosis and for appropriate treatment. The role of computed tomography is emphasized because it is the most commonly used modality to evaluate acute abdominal conditions as well as suspected renal masses, and the diagnosis can usually be made without the need for additional imaging modalities.