Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, with the highest incidences recorded in Southeast Asia, Africa, and the Pacific areas. Extrapulmonary TB cases have become more common since the appearance of the human immunodeficiency virus (HIV) and the increase in organ transplants. The main extrapulmonary TB sites are pleural, lymphatic, and urogenital TB. Renal manifestations of TB include proteinuria, hematuria, hypoalbuminemia, and renal dysfunction. Hematogenous dissemination occurs after vascular erosion, usually of a pulmonary vein, with embolism of microorganisms occurring through the systemic circulation. In the kidneys, the preferred site for colonization by M. tuberculosis is the medullary region, where granulomatous lesions may appear with caseous necrosis and, consequently, tissue destruction. Treatment includes rifampicin, isoniazid, pyrazinamide, and ethambutol for 2 months, followed by rifampicin and isoniazid for 4 months. More studies to investigate the main presentations of renal TB, as well as to develop more effective diagnostic methods and drugs for TB are required.