Papillary renal cell carcinoma (PRCC) is one of the second common subtype among all renal carcinoma. In this paper, it aimed at a 67 years old male patient with right multifocal papillary renal cell carcinoma (PRCC). Histologi-cal finding concluded papillae and tubular structures covered by mild small cells with pale cytoplasm and were character-ized by small oval nuclei. The neoplastic mesenchymal consists of foamy macrophages, necrosis, and cholesterol crystal. Immunohistochemically, all papillae and tubular structures express cytokeratin 7 (CK7), CD10, CK (AE1/AE3), alpha-meth-ylacyl-coenzyme A racemase (AMACR) and EMA; but was negative for antibody S-100. All the foamy macrophages show positive reactivity for CD68. The patient underwent right radical nephrectomy and survived well six months after the operation during our follow-up.