Bilateral nephrectomy for transitional cell carcinoma of the renal pelvis is a rare procedure. We report two cases of bilateral nephrectomy for transitional cell carcinoma. Both patients were placed on dialysis. A review of the literature revealed three other cases of transitional cell carcinoma treated with bilateral nephrectomies. Based on our experience and the review of current literature, we recommend a waiting period of 2 years on dialysis post-operatively before proceeding to transplantation.