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Ectopic kidney is a rare developmental anomaly. Such kidneys may be asymptomatic or present with vague symptoms or remain unknown during the lifetime. Early detection and recognition of an ectopic kidney can prevent long-term complications. We report a 70-year-old lady with ectopic right kidney who presented with intermittent episodes of lower abdominal pain since one month 1 month. On clinical evaluation a tender lump was palpable in the right lower quadrant of the abdomen. Sonography revealed empty right renal fossa with normally present left kidney. A mass was detected in the right lower abdomen, with probability of ectopic kidney. Further, Multislice computed tomography with 3-D reconstruction demonstrated ectopic right kidney at the level of L4 to L5 lumbar vertebrae. Urine examination revealed pyuria. The patient was managed on empirical antibiotics for UTI with supportive and symptomatic therapy. On the next day, clinically the lump regressed significantly (Dietl's crises) in size, and the tenderness also reduced. The urine culture report grew Escherichia coli. Patients presenting with lower abdominal pain, and a palpable lump in the lower abdomen, one must include ectopic kidney in the differential diagnosis.