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This report describes a case of small bowel obstruction caused by metastatic RCC in a male patient in his 60\u2009s who had previously undergone a radical nephrectomy with adjuvant pembrolizumab therapy 6\u2009years prior. The patient underwent a diagnostic laparoscopy converted to a laparotomy due to the complexity of the case. During surgical exploration, an enterectomy and end-to-end anastomosis were performed. This case emphasises the possibility of RCC metastasising to the small intestine, which may present with small bowel obstruction, while highlighting the importance of patient education for early detection to improve prognosis. Additionally, this report discusses treatment options for managing RCC metastasis to the small intestine.<\/jats:p>","DOI":"10.1136\/bcr-2023-254939","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T22:00:57Z","timestamp":1689717657000},"page":"e254939","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Metastatic renal cell carcinoma to the small bowel 6 years postnephrectomy"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6360-0087","authenticated-orcid":false,"given":"David","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Surgery, Arkansas College of Osteopathic Medicine, Fort Smith, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1929-8647","authenticated-orcid":false,"given":"Gasinee","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Surgery, Arkansas College of Osteopathic Medicine, Fort Smith, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6632-9069","authenticated-orcid":false,"given":"Kelsey Kay","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Arkansas College of Osteopathic Medicine, Fort Smith, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3765-9151","authenticated-orcid":false,"given":"Jason","family":"Loden","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cape Surgical Clinic, Cape Girardeau, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"2025082708394641000_16.7.e254939.1","unstructured":"Garfield K , LaGrange CA . 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