A horseshoe kidney is the most common renal embryological abnormality, but its association with an abdominal aortic aneurysm is rare. The conbination of a horseshoe kidney with a renal carcinoma and an abdominal aortic aneurysm is extremely rare and, to our knowledge, has only been reported twice in the English literature (Hinyokika kiy 46 (2000) 15; Eur J Vasc Endovas Surg 22 (2001) 280).