The recent introduction of drugs that inhibit angiogenesis or the mTOR has provided new options for the treatment of metastatic renal cell carcinoma, a disease which often has a poor prognosis. Chemotherapy and cytokine therapy are largely ineffective. The 5-year survival rate is under 10%. Everolimus, an immunosuppressive drug widely used for the prevention of allograft rejection and an mTOR inhibitor, is one of the latest drugs undergoing clinical trials in metastatic renal cell carcinoma. It has been tested in patients with progressive disease after therapy with tyrosine kinase receptor inhibitors (sunitinib, sorafenib or both), which interfere with signaling pathways, such as the VEGF pathway. Clinical efficacy results (progression-free survival) for everolimus are promising and the safety profile is good.