Kidney cancer affects over 80,000 Americans annually, with renal cell carcinoma as the dominant type. Benjamin R. Lee, MD, MBA, outlines current AUA guideline recommendations, including when to choose nephron-sparing surgery over radical nephrectomy and the importance of genetic counseling in younger or high-risk patients. Robotic partial nephrectomy is now standard for many tumors up to 11 cm, offering favorable outcomes with shorter recovery times. The approach to recurrence involves a tailored algorithm of surgery, ablation, or surveillance. Advances in immunotherapy and targeted therapy continue to shape treatment, especially in patients with advanced or metastatic renal cell carcinoma.