Glomerular tip lesion is frequently used to defi ne a histological variant of focal segmental glomerulosclerosis. Most patients with glomerular tip lesion have nephrotic syndrome and show a good response to steroid treatment. The glomerular tip variant is defi ned as having the best prognosis compared to the other histological variants of focal segmental glomerulosclerosis. Acute renal failure with glomerular tip lesion has been reported rarely in the literature. In this report, we discuss a patient presenting with nephrotic proteinuria and acute renal failure diagnosed as glomerular tip lesion with the relevant literature.