Renal lymphoma is most often seen in conjunction with multisystemic, disseminated lymphoma. Renal lymphoma may also be seen as primary disease. Computed tomography (CT) is the most sensitive, and comprehensive examination for evaluation of the kidneys in patients with suspected renal lymphoma. Helical CT in particular improves detection and characterization of lymphomatous renal involvement by optimizing contrast dynamics and data acquisition and is the current modality of choice for accurate staging of lymphoma. Typical CT patterns in renal lymphoma include single or multiple masses, invasion from contiguous retroperitoneal disease, perirenal disease, and diffuse renal infiltration. Atypical CT patterns may also be encountered and provide a diagnostic challenge. These include spontaneous hemorrhage, necrosis, heterogeneous attenuation and calcification. Solid renal masses including renal cell carcinoma and metastases are the most commonly encountered entities that mimic renal lymphoma at CT and require biopsy for definitive diagnosis. Helical CT is useful in the evaluation of patients with suspected renal lymphoma; and familiarity with the spectrum of findings in renal lymphoma is important for accurate diagnosis.