The overall incidence of renal cell carcinoma is rising, for reasons not fully explained by increased abdominal imaging. Risk factors associated with renal cell carcinoma include hypertension, smoking, increased body mass index, and diet. There is an inverse association of renal cell carcinoma risk with consumption of a variety of carotenes. In addition, increased red meat intake has been associated with increased risk. Partial nephrectomy may be as effective as radical nephrectomy as treatment for localized disease, and radiosurgery may be as effective as surgical resection in the management of brain metastases. Immunotherapy remains the mainstay for systemic treatment, with response rates between 5% and 20%. Survival in renal cell carcinoma is related to pathologic stage, nuclear grade, microscopic vascular invasion, DNA content, nuclear morphometry, and histologic pattern. In addition, patients with deletion (8p)/-8, +12, and +20 appear to have a worse prognosis.