Identification of tumor-, patient-, or treatment-related prognostic factors in renal carcinoma (RC) would allow the most appropriate application of current and future therapy to patients with this poorly responsive malignancy. Stage, including degree of lymph node and venous involvement, and grade remain the most powerful predictors of patient outcome. Performance status (PS) of patients also influences prognosis, as it relates to tumor aggressiveness and ability to receive adequate treatment. Newer techniques of measuring tumor proliferation and the application of cytogenetics to RC are currently being explored and may add to prognostication. Lastly, characteristics of tumor metastases and the appropriate application of surgical and chemotherapeutic treatment modalities allow for identification of patient subgroups with different survival times. This review explores various characteristics as they impact on overall survival in patients with RC.