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Metastatic renal cell carcinoma (RCC) disseminates to unusual organ sites and few patients derive long-term survival by surgery.However, synchronous metastasis of RCC to the contralateral adrenal gland and pancreas is extremely rare.In this report, we describe a case of synchronous RCC metastases to the contralateral adrenal gland and pancreas in a 55-year-old patient with a 116 × 92 × 61 mm right renal tumor and a 96 × 79 × 57 mm left adrenal lesion.We performed right nephrectomy for the RCC, left adrenalectomy for the adrenal tumor, and resection of pancreatic metastases in 2007.The patient was alive at the 7-year follow-up.