This retrospective study was conducted to evaluate the long-term results of transarterial embolization with absolute ethanol (ethanol-TAE) for patients with renal cell carcinoma (RCC). Twenty-eight patients, including 15 stage IVb patients, underwent ethanol-TAE, with 12 of them followed by nephrectomy. The cumulative survival rates after 1, 3, and 5 years were 71%, 54%, and 54% in the surgical group, and 54%, 33%, and 22% in the non-surgical group. From the results, we recommend ethanol-TAE for advanced stage patients for the following reasons: first, it can be a useful alternative to nephrectomy in high-risk patients; second, ethanol-TAE can decrease the primary tumor size increasing operability; and third, local tumor control may result in longer survival.