Missed diagnosis and misdiagnosis of cryoglobulinemia with renal impairment are very common in clinical practice. It is essential to grasp the clinicopathological characteristics of cryoglobulinemia with renal impairment, especially to the awareness of checking cryoglobulins in order to reduce the missed and misdiagnosis. In this article, we reported 1 case of renal impairment induced by cryoglobulinemia, with clinical manifestations of acute nephritic syndrome, elevated serum creatinine and hypertension. The patient had increased cryoglobulin level but decreased complement level, and were positive to rheumatic factor but negative to hepatitis C virus. After admission, the patient was finally diagnosed as renal involvement associated with type Ⅱ cryoglobulinemia (monoclonal IgM+polyclonal IgG) based on clinical, laboratory and pathological findings, especially for cryoglobulin. We hoped that this report will promote the awareness and diagnosis of the disease for clinicians.