Co-existent crescentic glomerulonephritis and renal amyloidosis have only rarely been reported thus far. To our knowledge, only about eighteen convincing cases (with >50% crescents) have been described, mostly in the context of rheumatoid arthritis. In this report, we add a case from our institution and review the existing literature, including a proposed mechanism of crescent formation in this setting. Although the relationship between crescentic glomerulonephritis, renal amyloidosis, and rheumatoid arthritis needs further investigation, we suggest that one should consider the development of crescentic glomerulonephritis with amyloidosis in patients with long-standing rheumatoid arthritis and worsening renal function.