Injury to the renal vasculature is an uncommon occurrence in the setting of blunt abdominal trauma. The authors report the case of a 2-year-old girl who developed occlusion from an intimal flap in a renal artery (grade IV renal injury) after blunt abdominal trauma that was treated with a stent placement. The stent procedure was technically successful in establishing renal artery flow. However, several months after the procedure, the patient developed stenosis within the stent and ultimately required a nephrectomy. To the authors' knowledge, this is the first report of percutaneous management of an acute intimal flap in a renal artery in a 2-year-old.