A 66-year-old man with a history of recurrent urothelial carcinoma in situ treated with endoscopic resection and induction Bacillus Calmette-Guerin (BCG) developed a new renal mass on surveillance computerized tomography and was referred to our institution for surgery. Biopsy was performed and pathology showed BCG granuloma. The patient was clinically asymptomatic. No surgical intervention was required. This is a rare entity in those undergoing intravesical BCG therapy. To avoid unnecessary surgery, a careful patient history and judicious use of renal mass biopsy is critical.