Primary renal carcinoid is an uncommon tumor. We report a case of local recurrence and multiple lymph node metastases of renal carcinoid 4 years after partial nephrectomy in a 64-year-old man. He was incidentally found to have a mass lesion in the right kidney and right partial nephrectomy was performed 4 years ago. Histological examination including immunohistochemical studies confirmed the diagnosis of the atypical primary renal carcinoid. After 4 years of follow up, abdominal ultrasonography and computed tomography demonstrated a local recurrence and multiple lymph node metastases around the inferior vena cava. He underwent right radical nephrectomy with paraaortic and right renal hilum lymphadenectomy. Histological appearance showed that recurrence of the atypical renal carcinoid. Four of the resected five lymph nodes were positive for metastasis. Unexpectedly, two tiny renal cell carcinomas were also found from the right kidney. The patient remains free from disease recurrence for 2 months post re-operation. This case is the 43rd report of renal carcinoid tumor in Japan.