Renal cell carcinoma remains a challenge for oncologists, with only 20% of patients being cured by surgical removal of the involved kidney and a handful of patients with advanced disease being cured by surgery, immunotherapy, or both. Although advances in early detection, recognition of high-risk groups, and chemotherapy remain disappointing, advances in immunotherapy as well as our basic understanding of the renal carcinoma cell have been made. Translation into clinical trials will likely occur within the next few years based on these findings.