Simple renal cysts are among the most common cystic lesions of the kidney. Renal cysts most often remain asymptomatic, but rarely these cysts may become huge in size and result in significant symptoms. Giant renal cysts present a technical challenge in terms of surgical management. Although laparoscopic procedures have been performed successfully at experienced centres, intraperitoneal marsupialization via open approach may be a feasible option at less experienced centres. We report a case of a young female with a giant (24 × 18 cm) renal cyst of Bosniak type-II variety. De-roofing and intraperitoneal marsupialization of the cyst was performed. At the 1-year follow-up, she was asymptomatic, with no residual cyst

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