Perioperative acute renal failure can be induced patient’s underlying disease medical history, drug, massive bleeding, hypotension, hemolytic uremic syndrome, sepsis, disseminated intravascular coagulation and surgical stress. In 2-7% of patients with acute renal cortical necrosis with partial or complete necrosis of the renal cortex is appeared. In the case of acute renal cortical necrosis, the blood flow of the renal cortex is blocked, causing anuria and oliguria, and the prognosis is poor due to necrosis of the renal tissue. A 48-year-old woman underwent laparoscopic myomectomy without massive hemorrhage. After surgery she medicated tranexamic acid, accompanied by complications to anuria, oliguria, acute renal cortical necrosis and finally affected chronic renal failure.