Abdominal stab wounds represent approximately 7% of abdominal injuries in our environment. However, renal involvement in these cases is relatively uncommon (2% of visceral lesions). We present a case of a stab wound in the anterior abdominal wall. In addition to intestinal lesions, the injury produced a lesion in a horseshoe kidney, a relatively uncommon malformation of the urinary system (1/400 individuals). Despite the rarity of this occurrence, when dealing with an emergency affecting a malformed kidney, knowledge of the inherent peculiarities of these defects is essential for the appropriate management of these patients.