This paper describes a clinical case of the treatment of a patient with associated abdominal aortic aneurysm and a horseshoe kidney. Examination revealed type II blood supply of the horseshoe kidney according to Crawford. The operation was performed from thoraco-phreno-lumbotomy on the left. During operation, we ligated the accessory renal artery with a good retrograde blood flow, branching out just from the aneurysmal sac. Examination carried out in the early and long-term postoperative period did not discover renal malfunction as shown by laboratory and radionuclide research methods.