A 63-year-old man was admitted to our hospital with gross hematuria. Abdominal computed tomography showed an 80mm right renal tumor, 31mm left renal tumor, and 30 mm splenic tumor. Cystoscopy revealed a papillary tumor around the left orifice. Right radical nephrectomy and splenectomy were performed. Histological examination findings showed that the right renal tumor was a renal cell carcinoma, clear cell type, G1, INFalpha, pT2, ly0, v0, and that the splenic tumor was an arteriovenous fistula. Next, transurethral resection of the bladder tumor was performed and a histological examination showed urothelial carcinoma. Magnetic resonance imaging indicated that the left renal tumor was a renal pelvic cancer. Left total nephroureterectomy and cystectomy were performed, and the histological diagnosis was urothelial carcinoma, G3, pT3, ly1, v2. Following the operation, hemodialysis was introduced. It is rare for a renal cell carcinoma and contralateral renal pelvic cancer to occur simultaneously, as only 15 cases including the present have been reported in Japan.