Objective To summarize the clinical characteristics and treatment methods of renal lymphangiectasia. Methods The clinical data of 2 patients with renal lymphangiectasia admitted from December 2008 to June 2010 were analyzed. Case 1, female, 37 years old. She had right lumbar abdominal pain for 8 d. Ultrasound examination showed mixed echoes around both kidneys, which were poorly demarcated from the kidneys, and CT examination showed hypodense shadows under the perinephric membrane of both kidneys, which were mixed with scattered punctate high-density shadows. After 3 weeks of conservative treatment, the pain was relieved, and 3 months later, the right lumbar pain was aggravated, and CT examination showed a large amount of fluid under the perinephric membrane of the right kidney, which disappeared after ultrasound-guided puncture and drainage, and ultrasound examination was repeated 2 months later, which showed a small amount of fluid in the perinephric membrane of the right kidney, and routine fluid and tumor cell examination was performed after puncture and aspiration of the fluid. Case 2, female, 32 years old. Left lumbar pain and discomfort for 3 years, ultrasound examination showed irregular cystic lesions around the left kidney, CT examination showed lobulated cystic lesions in the posterior and posterolateral part of the left kidney, with unclear demarcation from the renal parenchyma, and anterior displacement of the left kidney under pressure. Lymphangioma of the left kidney was diagnosed and lymphangiectomy was performed under epidural anesthesia. Results Example 1 cystic fluid smear showed a large number of lymphocytes and a small number of neutrophils, which was considered to be lymphatic fluid, and the clinical diagnosis was renal lymphangiectasia, and no recurrence was seen at 2-month follow-up. Case 2 was diagnosed as renal cystic lymphangioma after postoperative pathological examination of the cyst wall lined with flat epithelial cells with lymphocytic infiltration and cystic dilatation of lymphatic vessels. No recurrence was seen in 9 months of postoperative follow-up. Conclusion Ultrasound and CT examination are helpful for the diagnosis of renal lymphangiectasia, and puncture cytology and histopathology can confirm the diagnosis. Asymptomatic patients can be closely followed up, symptomatic patients can be drained by puncture, but the recurrence rate is high; or surgical resection of dilated lymphatic vessels + anhydrous alcohol to destroy the endothelial cells can also be used for treatment, which has a low recurrence rate, but lymphatic leakage may occur.