Background: Percutaneous renal cyst aspiration and sclero-therapy are considered as single, a safe and minimally invasive procedure currently practicing by numerous uro-surgeons currently in the treatment of simple symptomatic cysts. Objectives: This study was designed to assess the effectiveness and complications of ultrasound (US) guided percutaneous aspiration of renal cysts with 99% ethanol as sclerosing material in the treatment of simple symptomatic renal cysts. Methodology: This observational prospective study was done among 42 patients who had a total of 47 symptomatic simple renal cysts. It was carried out during the period from 2014 to 2017 in the Outpatient Clinic of MOH. The patients' age ranged between 23-62 years including male (19) and females (23). An US guided ablation of renal cyst was done under local anesthesia. After that, an equal volume of contrast medium was injected through the needle into the cyst cavity to delineate the cyst wall. The sterile 99% ethanol, with one fourth of total cyst volume was injected into the cyst after complete aspiration of the contrast medium. After that, the ethanol was aspirated, and volume was measured. Results: The complications were minimum including, hematuria in 8 patients (17%), low-grade fever in 7 patients (14.8%) and mild flank pain in 5 (10.6%) patients were observed. During the follow-up after the sclerotherapy, out of 47 cysts, 20 (42.5%) cysts with different sizes showed statistically significant (P < 0.05) complete resolution and not appeared again during the later follow-up sessions. The overall success rate in the current study procedure was 100%. Conclusion: Percutaneous aspiration with a single injection of 99% ethanol sclerotherapy gave a high success rate in the treatment of simple renal cysts with good optimization of sclerosing material and effective aspiration skill of uro-surgeon.