Background: We report a rare case of tuberous sclerosis complex with bilateral renal masses that was managed conservatively using mTOR inhibitors. Case Report: A 18 year old girl presented with right flank pain and features of tuberous sclerosis complex. Imaging revealed bilateral, large, heterogenous, enhancing renal masses. The patient was successfully managed with sirolimus and is on regular follow up with no complications. Conclusion: We conclude that renal masses in tuberous sclerosis complex can be managed on sirolimus.