Primary retroperitoneal structures, particularly kidneys, are considered ‘fixed’ to the posterior abdominal wall by fasciae and vascular pedicles from the great vessels. However, huge masses arising in the retroperitoneum – either benign or malignant – are found to exert a mass effect in the retroperitoneal and intraperitoneal compartments, resulting in ‘visceral midline shift’. We present three different cases of retroperitoneal swellings causing extreme anatomical distortions in the abdomen and their surgical implications.