We describe a case of bilateral renal cell carcinoma with the tumor thrombus in the inferior vena cava. A 71-year-old male was admitted to our department for, careful examination of bilateral renal tumors. Abdominal computed tomography (CT) revealed bilateral solid enhanced renal masses with the tumor thrombus in the inferior vena cava (IVC) and the left renal vein. The renal tumor did not reveal distant metastatic lesions. We enforced two-term operation for bilateral renal tumor. First, right nephrectomy and tumor thrombectomy in the IVC were performed. On the 32th day after the first operation, we performed left nephrectomy. On the second day after the last operation, the patient received hemodialysis. The histopathological diagnosis revealed bilateral renal cell carcinomas. At 9 months after the last operation, the patient had multiple bone metastases, multiple liver metastases and multiple lung metastases.