Mounting evidence suggests that, in order to optimize therapeutic benefits, it is important to consider the range of parameters and characteristics relevant to each individual patient. Of note, the six targeted therapies currently approved for the treatment of advanced/metastatic renal cell carcinoma have not been evaluated in all relevant settings and in all prognostic groups. Among different agents currently licensed for the treatment of renal cell carcinoma, sorafenib was the first therapy to show improvements in progression-free survival and overal survival in Phase III trials. This article will discuss the current role of sorafenib in the treatment of elderly patients with renal cell carcinoma.