Summary : R.C.C accounts for 3% of adult malignancies. It occurs in middle age mainly, median age is 50 years. It is very rare in children. It is most common in males with a male female ratio of 3:2. In my review it was more common on the left side but this fact is not proved internationally. Most cases at presentation are advanced as symptoms of pain, haematuria, swelling are indicative of advanced disease. The majority of cases are stage 3 and stage 4. The most common pathological subtype was renal carcinoma not otherwise specified, followed by clear cell carcinoma, then granular cell carcinoma. Sarcomatoid type is rare and often indicative of bad prognosis. Factors with poor prognosis are: renal vein involvement, extension to regional lymph nodes, extension through Gerota's facsia, involvement of contiguous organs and distant metastasis. The great majority of cases were found with no renal involvement. Lymphadenectomy was done for a large proportion of cases and 13% only were found with positive nodes. C.T is considered the most commonly method of diagnosis. If a cystic renal mass lesion appear potentially malignant by C.T, evaluation of cyst fluid by C.T guided biopsy can be done.Pain was the most prominent symptom given by the patients 60% of patients gave history of pain and this indicate that most cases on diagnosis are already advanced locally. Hypochromic anaemia occur in 12% of patients. R.C.C has remained resistant to most forms of therapy other than surgery. Radical nephrectomy has become the standard form of treatment and better if combined with lymphadenectomy. It has never been proved to be beneficial regarding radiotherapy as adjuvant for R.C.C. Criteria for giving postoperative radiotherapy were positive surgical margin, capsular infiltration, high grade or sarcomatoid subtype and positive paraaortic nodes. R.C.C has remained refractory tocytotoxic agents .Chemoembolization didn’t produce great results ,may be because of bad technique. Immunotherapy improved response rate occur when given with removal of diseased kidney otherwise it had no great role in management of R.C.C. There is little evidence to support hormonal treatment today. Aggressive therapy of solitary lesions of skeleton, C.N.S and soft tissue produced significant palliation of symptoms and prolonged survival. Most favorable lesions for resection are solitary pulmonary metastasis. Palliation of symptoms is a reasonable rationale for nephrectomy in the face of metastasis provided the primary tumor can be completely removed without undue morbidity