Renal oncocytoma is usually detected incidentally. It can be considered as a renal cell carcinoma (RCC) on preoperative imaging. They usually present as small masses and usually look like benign tumors. Giant oncocytomas are rare. A 72-year-old male patient was seen in the outpatient department for left scrotal swelling. Ultrasound (US) showed a giant mass compatible with RCC in the right kidney which was incidentally detected. Abdominal computed tomography (CT) revealed a mass with an axial diameter of 167×146 mm, compatible with RCC, a heterogeneous mass of soft tissue density with central necrosis. There was no evidence of tumor thrombus in the right renal vein or inferior vena cava. Open radical nephrectomy was performed through an anterior subcostal incision. Pathological examination revealed a 17×15 cm renal oncocytoma. The patient was discharged on the sixth day postoperatively. Clinically or radiologically, renal oncocytoma and renal cell carcinoma usually cannot be distinguished, although oncocytoma may be suspected if a central scar with fibrous extensions is seen, the so-called "spoke-wheel appearance". The treatment decision should be made according to the clinical aspects. Radical/partial nephrectomy or thermal ablation can be considered as treatment options. In this article, we review the literature on the radiological and pathological features of renal oncocytoma.