Emphysematous pyelonephritis is an uncommon serious suppurative infection chracterized by the production of intrarenal and perirenal gas and generally occurs in patient with diabetes mellitus or urinary tract obstruction. We report a case of emphysematous pyelonephritis treated successfully with percutaneous drainage in 67 year old diabetic woman with contralateral atrophic kidney and pneumonia. She has been treated with anticoagulant due to acute cerebral infarction.