Introduction: Giant hydronephrosis is a rare entity and mostly in the literature, it is published from developing countries. Case Report: We reported a case report in a 64-year-old male patient who presented with a big abdominal lump occupying almost half of the right side abdomen. Ultrasonography and Contrast-enhanced computed tomography were done for the diagnosis and further characterization. After decompression by percutaneous nephrostomy (PCN), elective nephrectomy was done as the kidney was non-functioning. Conclusion: We should never forget this unexpected entity in the differential diagnosis of an abdominal lump in this age group.