Renal angiomyolipoma is a benign tumor formed by smooth muscle, adipose tissue and blood vessels. It is commonly found incidentally and its clinical manifestations are pain and abdominal mass or spontaneous tumor rupture with retroperitoneal bleeding. The clinical presentation of a hemorrhagic shock secondary to a retroperítoneal hematoma is uncommon. We report a 40 year-old male who presented to the emergency room with lumbar pain and deteríoration of hemodynamic parameters. The CT sean showed a left renal injury associated to an expansive retroperítoneal process. The abdominal exploration, vascular control of the renal pedicle and nephrectomy allowed a successful outeome.