The authors propose a classification of ex situ surgery of the kidney and present their clinical experience of 20 renal autotransplantations over a period of 6 years: 16 were performed for renovascular hypertension with 2 failures and 4 for recurrent staghorn calculi, with 1 stone recurrence. Based on their experience and on the literature they discuss the present status and the future implications of ex situ surgery of the kidney.