This is a 5 year old girl, presenting to her primary physician with abdominal mass. Initially was evaluated by ultrasound and the mass was seen arising from the left kidney. Further characterization and evaluation of this lesion were done by CAT scan with intravenous contrast enhancement. The left renal mass was clearly seen showing typical features of Wilms tumor depicting claw sign and lack of calcification. Unfortunately, lung metastases were identified with enlarged retroperitoneal and mesenteric lymph nodes, but no evidence of bone metastases. It was identified as stage IV disease, unfortunately.