We present a case of bilateral multifocal Wilms tumor in a nonsyndromic 12-month-old male. Our management approach included 12 weeks of preoperative chemotherapy for maximal tumor shrinkage and, despite the central location of the tumors, successful staged bilateral nephron-sparing surgery. We advocate for a broader application of nephronsparing surgery in Wilms tumor cases with the goal of preserving renal function without compromising oncologic outcomes. (C) 2018 Elsevier Inc.