Horseshoe kidneys are congenital anomalies that result from the fusion of the right and left kidneys across the midline of the abdomen after both kidneys failed to ascend during fetal development. During a standard educational dissection of 12 donor bodies from the Body Donor Program at PCOM Georgia, a horseshoe kidney was discovered in an 88-year-old female with a reported fatality related to left lung carcinoma, encephalopathy, and hypercalcemia. The circumstances of this discovery presents an opportunity to explore the anatomical arrangement of the congenital malformation in detail. Anatomical dissection and analysis of the neurovascular and renal organization was documented with marked differences from traditional structural arrangement. A parenchymatous isthmus was formed superficial to the abdominal aorta by the fusion of the lower poles of the right and left kidneys. Additionally, other anatomical abnormalities present were identified and recorded. This study could be utilized to inform providers of best practices regarding patients with horseshoe kidneys.