Renal pelvic cancer with a large vein tumor thrombus is very rare. We report a case of transitional cell carcinoma of the right renal pelvis with tumor thrombus in the inferior vena cava. Based on the radiological findings, the patient was diagnosed having renal cell carcinoma with tumor thrombus in the vena cava preoperatively. Radical nephrectomy with thrombectomy was performed. A literature review of 17 reported cases revealed that 13 cases (76.5%) were diagnosed as renal cancer preoperatively. Prognosis of transitional cell carcinoma with vena cava tumor thrombus is relatively poor compared to that of renal cell carcinoma with a large vein tumor thrombus.