Renal sinus lipomatosisis are condition, seen in the kidneys of elderly patients. Disease is usually unilateral and associated with renal calculi. There is proliferation of excessive lipomatous tissue in renal sinus, renal hilum and peri-renal space. Presentation of disease is varied, ranging from chronic renal pain to features of renal abscesses or pyonephrosis. Here we reporta interesting case of bilateral renal sinus lipomatosis mimicking as emphysematous pyelonephritis.