Renal cell carcinoma is an urologic malignancy with poor prognosis. Local invasion and distant metastasis determine the prognosis of the disease. Dissemination to inferior vena cava via renal vein is seen in 4-10% of the patients. The role of radiotherapy and chemotherapy is limited, surgery is the only curative treatment option and patients with liver metastasis also benefit from surgery. In patients with vena cava trombosis, cavotomy and trombectomy should be done to prolong survival, if nodal or visseral metastasis is not present. Surgical procedure differs according to location of trombus in inferior vena cava. In our case report, a patient treated with right nephrectomy due to renal cell carcinoma 3 years ago who was re-operated for vena caval trombus is mentioned. Operation was done without using Pringle technique (clamping of hepatic pedicle) by mobilization of the liver with piggy back technique, and after cavotomy and trombus excision, defect in vena cava was reconstructed with PTFE prosthetic graft. Here, we report this case and discuss it in the light of current literature.