Botryoid growth pattern (BGP) is a polypoid mass growing into the renal pelvis, rarely seen in bilateral Wilms tumors (BWT) where it represents a surgical challenge. We report our experience of nephron sparing surgery (NSS) in three patients with BGP in BWT. Surgical en-bloc removal was performed after calyx opening with no complications. The histology of the BGP was Intra Lobar Nephrogenic Rest in all cases while all Wilms tumors were of intermediate risk. One patient early recurred. At a follow-up of 9 months, 22 and 23 years, all patients were alive with a moderate renal insufficiency and hypertension.