Patients with end stage renal disease (ESRD) secondary to acquired renal cystic disease or chronic hemodialysis have a higher incidence of renal cell carcinoma than the general population. The aim of this study was to examine the clinical significance of renal cell carcinomas detected with computed tomography (CT) in native kidneys of patients with ESRD. We reviewed abdomen CT images of patients on dialysis and with renal transplantation treated at our institutions over the last ten years. We identified eight patients with ESRD and renal cell carcinoma. CT findings, histologic types and clinical outcome of tumors were noted. A total of eight patients had malignant renal lesion. Six patients were on hemodialysis, 1 patient were on peritoneal dialysis and 1 patient had functioning renal transplant. Three patients had cystic neoplasm and 5 patients had solid masses in CT. The size of the tumors were between 0.5 and 8 cm. Six patients had stage 1 disease (T1,N0,M0), 1 patient had stage 3 disease (T2,N1, MO) and 1 patient had stage 4 disease (T1N1M1). Mean Fuhrman nuclear grade was 2.12. Since there is no urine formation in dialysis patients, dialysis patients with renal cell carcinoma are usually asemptomatic. Therefore screening is necessary for renal cell carcinoma in patients with ESRD who are on dialysis and awaiting renal transplantation, and also in patients with renal transplantation due to immunosuppressive drugs which may cause tendency to neoplastic growth.