A 37-year-old female presented with abdominal pain. An abdominal computed tomography scan demonstrated a 10 cm x 13 cm left renal mass. An open adrenal-sparing radical nephrectomy was performed. The pathological diagnosis was epithelioid angiomyolipoma. Five-year surveillance did not demonstrate recurrence of disease. However, a 1.8 cm x 2.5 cm mass on the rectus abdominis muscle was identified after 5 years. Biopsy of the mass demonstrated histologic findings consistent with the primary tumor. Herein, we report a case of metastatic renal epithelioid angiomyolipoma to the rectus abdominis muscle more than 5 years after resection of primary renal tumor.