In this case report, we describe a young male patient who presented with gross hematuria and nephrotic syndrome a few weeks after serologically positive acute hepatitis E virus (HEV) infection. Histopathological examination of renal core biopsy revealed that the majority of the viable glomeruli had a predominantly mesangiopathic process characterized by mild to moderate diffuse increase in mesangial matrix and cellularity with segmental variation. Immunofluorescence microscopy depicted a strong (3+) granular mesangial and capillary loop staining for IgA, consistent with IgA nephropathy (IgAN). This pattern of mesangial and glomerular capillary loop staining of IgA is suggestive of secondary IgAN. Further research is required to explore the relationship between IgAN and acute HEV infection.