The survival rate for renal cancer patients is closely related to the surgical margin status. Thus, accurate and rapid detection of renal cancer is needed. Here, we integrated photoacoustic tomography (PAT) with ultrasound imaging in a single system, which achieved tissue imaging depth about 3 mm and imaging speed about 3.5 cm2/min. We used the wavelength at 1064 nm and 1197 nm to map both blood and lipid distribution in 16 normal and 17 clear cell renal cell carcinoma (ccRCC) tissues, collected from nephrectomy. Our results indicated that the photoacoustic signal from lipids, but not blood, was significantly higher in ccRCC tissues than that in normal tissues. Moreover, based on the quantification of lipid area ratio, we were able to differentiate normal and ccRCC with 100% sensitivity, 80% specificity, and area under receiver operating characteristic curve of 0.95. Our findings show promise of using multimodal PAT for intraoperative ccRCC detection.