A 60-year-old woman with polycystic kidney presented with intracystic hemorrhage; renocolic fistula was diagnosed by contrast-enhanced. The patient was admitted due to hematuria, pyuria and pneumaturia. Abdominal B-mode ultrasonography showed that this renal cyst had thickened walls and debris-like internal echo. Truagent Detection, a power Doppler imaging mode, could depict intracystic color signals after Levovist injection by real-time scan. Enhanced spots had increased in the cyst, and were shown as minimal intracystic hemorrhage in real-time. The case of polycystic kidney with renocolic fistula is rare, however contrast-enhanced ultrasonography could successfully identify the site of minute bleeding.