Wilms’ tumor is one of the most frequent tumors in childhood. The incidence of Wilms’ tumor in a horseshoe kidney is estimated at 0.4 to 0.9%. It is highly treatable but a fast growing tumor. Management of cancer patients has become a dilemma for surgeons, due to the impact of the COVID-19 pandemic on the health care sector globally. Reported here is a rare case of a 2 year old boy, diagnosed with Wilms’ tumor in a horseshoe kidney. This report aimed to highlight the multimodality treatment of Wilms' tumor and the modifications to cancer diagnostic and treatment protocols to adapt to the current health care crisis brought about by the pandemic.