Surgical treatment of severe renal trauma usually ends in loss of high percentage of kidneys. In consequence of this, in the last decade several authors prefer a conservative management of kidneys severely injured. There include stabilization in Intensive Care Unit, with the goal of preservation the most possible functioning renal tissue. The purpose of this paper is to present the results of conservative management of severe renal trauma in our Center in the last five years. We conclude that this type of management is accurate and effective.