A 60‐year‐old Caucasian woman was found to have bilateral adenocarcinoma of the kidney. A transabdominal left radical nephrectomy with right partial nephrectomy was performed as a single operation. The main advantages of this more aggressive simultaneous bilateral surgery are better exposure, the ability to rule out intra‐abdominal metastasis, and the avoidance of the necessity of leaving the patient with viable malignant tissue while awaiting a second surgical procedure. The immediate postoperative course was essentially uneventful, and the patient is now over 4 years post‐surgery without evidence of morbidity or tumor recurrence. A review of the literature describing similar cases and alternate methods of management is presented.