A renal artery aneurysm is a dilated segment of the renal artery that is larger than twice the diameter of a normal renal artery. Despite its rarity, the diagnosis and incidence of this entity have been steadily increasing as a result of the widespread use of cross-sectional imaging. Renal artery aneurysms can be clinically significant and potentially fatal in some cases. However, knowledge of their occurrence, natural history and prognosis, whether treated or not, is limited. We present a case of a renal artery aneurysm complicated by hypertension that did not respond to medical treatment and was treated with simple nephrectomy.