The authors report a case of bilateral renal metanephric adenoma in a 51-year-old patient, discovered during assessment of hypertension associated with microscopic haematuria. The left tumour was 60 mm in diameter and protruded into the renal pelvis. The right tumour was 11 mm in diameter and was situated in the external cortex. Treatment consisted of radical left nephrectomy due to the size of the tumour associated with right lumpectomy. Histological examination of the two tumours revealed a benign metanephric adenoma. In the light of this case and a review of the literature, the authors discuss the clinical features, complementary examinations and histological features of this rare renal tumour as well as the treatment modalities.