Introduction: High-grade renal injuries are managed either operatively or non-operatively depending on haemodynamic stability . In operative intervention, nephrectomy may be unavoidable. In children with solitary kidneys, long-term quality of life depends on successful preservation of kidneys as nephrectomy results in lifelong dependence on renal replacement therapy . Case Description: A previously healthy 5-year-old presented following fall from a height complaining of severe abdominal pain, one episode of haematuria and anuria for 12 hours. He was hemodynamically stable with haemoglobin 9.6g/dL, estimated glomerular filtration rate (eGFR) of 37ml/min/1.73m2. Computed Tomography revealed shattered right solitary kidney , separated into two segments across renal hilum with perinephric and retroperitoneal urinoma. Urine output was established following aggressive fluid resuscitation (40ml/kg) and frusemide (8mg/kg). Strict input–output monitoring was implemented with supportive therapy . Anuria recurred after 2 hours despite euvolaemia and diuretics. A JJ stent was inserted toconfirm ureteric continuity . Despite this, he remained anuric and developed respiratory distress requiring ventilation, raising suspicion of abdominal compartment syndrome. A percutaneous abdominal drain was inserted with successful drainage, alleviating ventilatory requirements and restoring urine output. Despite nadir eGFR of 15ml/min/1.73m2 he was discharged after 25 days with normal creatinine. Ultrasound scan at 6 weeks confirmed viability of kidney and resolution of collections. Conclusion: Non-operative management is a feasible, kidney-sparing approach in haemodynamically stable children. Successful outcomes depend on vigilant observation, meticulous fluid and electrolyte management, serial laboratory monitoring, and low threshold for intervention should deterioration occur. In this child, adherence to principles resulted in preservation of the kidney .