© 2016 by Nova Science Publishers, Inc. The percentages of incidentally discovered renal cell carcinoma (RCC) has increased recently due to the routine use of cross-sectional imaging in the diagnosis and follow up of different diseases. More than 50% of incidentally discovered RCCs are diagnosed in patients with advanced age, which is an age group associated with multiple comorbidities. Luckily, most RCCs are incidentally discovered at a very early stage (Stage 1A). The combination of early stage disease and multiple co-morbidities favored nephron sparing minimal invasive surgeries, such as ablation techniques. Cryosurgery plays an important role in the management of these patients and became one of the standard of care options for management of stage 1A RCC. When performed either percutaneously or laparoscopically, cryosurgery is considered the most frequently used ablative technique in management of RCC. Furthermore, cryosurgery has been well reported in the management of other non-RCC renal tumors. In this chapter, we aim to address all clinical aspects of cryosurgery including indications, selection criteria, contraindications, technical procedure considerations, complications, and post treatment follow up. We will summarize the current status of cryosurgery in the treatment guidelines along with the technical success and clinical outcomes of this technique, and compare it to other ablative techniques including the most recent ones such as irreversible electroporation (IRE), and high-intensity focused ultrasound (HIFU). Furthermore, we will discuss the future perspectives of cryosurgery in management of small renal tumors.