Renal Cell Carcinoma (RCC) is a common renal parenchymal malignancy. Although complete or partial nephrectomy is still the gold standard of management, a lot of minimally invasive techniques are currently emerging into the field of treatment. Recently, image-guided radiofrequency (RF) ablation has received increasing attention and been proposed as an alternation to more invasive procedures such as partial or radical nephrectomy. For the RCC patients who are not amenable to surgery or have a single kidney, RF ablation is another feasible option of management. We present a 71-year-old patient who had right nephrectomy for RCC 10 years prior to admission, and hypertension and arrhythmia under regular treatment. He was noted to have two masses in the left kidney and right adrenal gland, respectively, on follow-up computed tomography images. Percutaneous biopsies of the left renal and right adrenal masses were proven to be renal cell carcinoma. After a right adrenalectomy was performed, this patient underwent two treatment sessions of percutaneous RF ablation to avoid a nephrectomy which would lead her on dialysis. Successful treatment was impressed after 1 year of follow-up. We report this case to emphasize the potential role of percutaneous RF ablation on the treatment of RCC.