A 79-year-old woman presented with gross hematuria. She had undergone a right radical nephrectomy 2 years previously for G2 pT2 renal cell carcinoma, clear cell variant. Intravenous pyelography showed a filling defect in the left ureter. Systemic work-up demonstrated no evidence of other metastases. Partial uretectomy and end-to-end ureteroureterostomy were performed. Histology showed metastatic clear cell carcinoma consistent with the primary renal tumor. Six months after surgery, her serum creatinine was stable at 1.6 mg/dl and she was doing well without evidence of recurrent disease. Solitary metastasis of renal cell carcinoma to the contralateral renal pelvis or ureter is extremely rare, with only 7 cases having been reported. We herein describe the present case and review the relevant literature.