The kidneys are retroperitoneal organs applied to the posterior abdominal wall. Renal ectopia and structural alterations are of clinical significance. Most renal ectopia occurs in the pelvis and has a strong association with genitourinary pathologies. I the present study we report a rare case of bilateral pre-peritoneal pelvic renal ectopia with aberrant size, structure and renal vasculature. The ectopic kidneys displaced the pelvic viscera inferiorly. This pre-peritoneal position of the kidney is rarely reported. The aberrant kidneys bore an atypical internal structure with renal pelvis deeply situated into the parenchyma. These anatomical variations are not mentioned in the common standard anatomy text books for medical students and surgical residents. Due to their common occurrence, however, renal ectopia should be emphasized in normal anatomy class for medical students and surgical residents. Routine clinical guidelines should take into considerations these variations.
