Renal cell carcinoma is an uncommon but lethal disease. Since many patients initially present with metastatic disease and/or fail primary local therapy, therapeutic alternatives are needed. In our review of single agents none emerge as uniformly effective, although a number of chemotherapeutic agents are somewhat active, as is the hormonal agent, medroxyprogesterone. Combination chemotherapy, with and without hormonal agents and immunotherapeutics, appears to be somewhat more active, with several reports of CRs. Immunotherapeutic agents alone show promise in the limited studies reported to date. Several studies are now in progress, attempting to study new agents and combinations in this disease. Physicians are urged to participate in these studies.