56 years old male patient who was treated for mild pain in the left lumbar area and ultrasound revealed hydronephrotic kidney with thin parenchyma with RUS at PUJ with non-functioning kidney on intravenous urography (IVU) and renal scan confirmed non-functioning kidney with zero percent function on left side. Patient underwent left nephrectomy and histopathology report revealed kidney full of pus and tuberculosis.