A woman with oliguric post partum renal failure was studied by means of the xenon-133 washout technique, renal biopsy, and selective renal arteriogram. An arteriovenous fistula was found in the lower pole of the left kidney. The xenon-133 washout demonstrated a very rapid flow rate to the first compartment (1,439 ml/100 g/min), while other evidence suggested severe cortical ischemia. Spurious measurements of renal cortical perfusion may be obtained with the xenon-133 washout if an arteriovenous fistula is present.