Preoperative anatomical scoring system is helpful to comparison between management options and assessment of postoperative consequences in patients with small renal cancers. This study aimed to assess the value of the R.E.N.A.L nephrometry score (RNS) in foreseeing perioperative results in patients with renal tumor. thirty three patients who had restricted renal tumor overseen by open medical procedure between February 2018 to February 2020. Patients were isolated into three gatherings as indicated by their RNS (low, moderate, and high). Clinical attributes with perioperative factors, intricacies, and RNS were contrasted with evaluate the contrasts between the three gatherings. Multivariable calculated relapse investigation was utilized to break down the hazard variables of postoperative confusions. As per the RNS, there were 18, 10, and 5 patients in the low, moderate, and high RNS gatherings, separately. There were critical contrasts in evaluated blood misfortune, warm ischemia time, activity time, perioperative creatinine leeway change , and number of patients with intricacies among the three gatherings. The qualities for EBL, WIT, OT, PCCC, and NPC for patients in the high RNS bunch were higher than those for patients in the low RNS gathering. After alteration for OT, WIT, and EBL, RNS was factually essentially connected with the danger of postoperative complexities in a multivariable strategic relapse model (chances proportion = 1.541, 95% certainty stretch: 1.059–2.242, P = 0.024). The RNS is a significant device for assessing the unpredictability of renal tumor life systems. It can help specialists in preoperative dynamic concerning the board treatment. Future multicenter, huge example size examinations are justified for assessing its anticipating execution of perioperative results.