Fibrillary glomerulonephritis is a recently recognised condition. The usual presentation is heavy proteinuria. The diagnosis is established by demonstration of the characteristic Congo-red negative, randomly arranged microfibrils in the glomeruli by electron microscopy. At present, there is no proven effective treatment for this condition and the prognosis is generally poor. The first case of fibrillary glomerulonephritis diagnosed in Hong Kong is reported here in a 38-year-old woman.