Brain metastases of renal cell carcinoma (RCC) are generally seen in advanced stages of disease with a short life-expectancy. A solitary, synchronous brain metastasis of RCC is rare and neurological symptoms may be the presenting sign of cancer. An aggressive surgical approach is justified in patients with favorable prognostic factors (good performance status, age under 65 years, absence of extracraneal lesions) for palliation of symptoms and improvement of cancer-related survival.