During the past decade, there have been important progresses and innovations in both basic and clinical fields of renal cell carcinoma. Major advances have been observed in the understanding of pathogenesis of renal cell carcinoma both at molecular and genetic levels. Improvements in imaging technology, including computerized scan and magnetic resonance imaging, has allowed accurate and detailed preoperative staging. Surgical management was revolutionized with the widespread use of nephron sparing surgery as well as the introduction of laparoscopic and robotic techniques. New treatment modalities were introduced to the market such as tumor ablation and active surveillance. Recently, the approval of new drugs targeting specific carcinogensis pathways had improved survival in patients with metastatic disease. Herein, we reviewed changes in our knowledge in terms of pathogenesis, surgical and medical management of renal cell carcinoma. We also revisited clinical and pathological factors that govern outcome of renal cell carcinoma.