Renal carcinoma is a reasonably common cancer in the UK. Fortunately, its diagnosis is nowadays much earlier due to the increased utilization of radiological imaging. Whilst surveillance is an option, particularly in older/comorbid patients, nephron sparing surgery remains the gold standard treatment for small renal masses. Laparoscopic, robotic or open partial nephrectomy have excellent cure rates. For larger tumours, radical nephrectomy may be required. This again can be performed laparoscopically, robotically or in an open manner. The classic presentation of renal mass, haematuria and loin pain is a late presentation – many of these patients will already have metastatic disease. Although non-curable, treatments are available for metastatic disease. Surgical options in the form of cytoreductive nephrectomy and metastasectomy can improve overall survival. Tyrosine kinase inhibitors and other targeted novel agents contribute the non-surgical treatments and have demonstrated increases in survival.