7 year old boy with pain in abdomen on left side. CECT with 3 D reconstruction shows a ‘Horse - Shoe’ shaped kidney with obstructed left side kidney. Horseshoe kidneys are the most common type of renal fusion anomaly. A horseshoe kidney is formed by fusion across the midline of two distinct kidneys. They are connected by an isthmus of either functioning renal parenchyma or fibrous tissue. With a horseshoe kidney, ascent into the abdomen is restricted by the inferior mesenteric artery (IMA) which hooks over the isthmus. Hence horseshoe kidneys are low lying.