Abstract: Objective:To summarize our experience on surgical treatment of renal cell carcinoma with tumor thrombi of inferior vena cava. Methods:This retrospective study involved 12patients with renal cell carcinoma complicated with tumor thrombi of inferior vena cava. Radical nephrectomy plus vena cava thrombus removal were conducted in our hospital during the period from December 2003to December 2009. Results:Final diagnosis of renal carcinoma complicated by tumor thrombi of vena cava was made in all 12patients following preoperative CT scan and MRI examination. Tumor thrombi of renal vein or inferior vena cava were found in all the patients, with 2 of the 12cases having the tumor embolus of left renal vein,4 having tumor embolus of right renal vein, and 6 suffering the tumor embolus of vena cava ( 3 with sub-hepatic vena cava and the other 3 with intra-hepatic vena cava). All patients underwent radical nephrectomy and thrombectomy concurrently. Nine of the 12 patients were followed up for a period ranging from6 to 72months after surgery. Four of the12patients survived disease-free for 1 to 3 years, 4 survived disease-free for more than5 years, and 1 died with tumor recurrence6 months after surgery. Conclusion:Radical nephrectomy plus removal of vena cava thrombus can achieve a long-term survival for patients with renal cell carcinoma and vena cava thrombi and without regional and distant metastases.