Intravesical Bacillus Calmette-Guerin has proved to be the most effective treatment of superficial bladder carcinoma. This therapy may induce a renal failure of variable severity, sometimes associated with multiple organ failure. Renal prognosis of this complication is not well defined. We report on a 68 year-old male patient who developed granulomatous hepatitis and acute tubulo-interstitial nephritis with mononuclear infiltrates containing numerous epithelioid cells, following the third course of intravesical BCG. Eleven cases of renal impairment due to intravesical BCG have been previously described, as part of a systemic disease in seven patients. The potential pathophysiological mechanisms of this rare complication are precised.