Recent studies have outlined the emerging role of 68Ga-PSMA-11 PET/CT in the diagnostic algorithm of clear cell renal cellcarcinoma (ccRCC). We report a unique intra-patient comparison of bilateral primary ccRCC imaged with 68Ga-PSMA-11PET/CT. Although both tumors resulted 68Ga-PSMA-11 avid, we found a remarkable discrepancy in uptake intensity betweenthe high grade and the low grade ccRCC. This case confirms previous evidence reporting that SUVmax on 68Ga-PSMA-11PET/CT could be used to discriminate aggressive high grade from more indolent low grade ccRCC, due to their differentendothelial expression of PSMA.