Renal cell carcinoma (RCC) is a potentially curable disease, especially if the tumor is limited to the kidneys and no systemic metastatic spread has occurred by the time of diagnosis. Despite the potential for successful surgical removal of the tumor-bearing organ in localized stages and the likelihood of treatment success, the complications and long-term morbidity and mortality of RCC are difficult to accurately predict. The currently used drugs were developed based on the understanding of the molecular details of pathogenesis at the time, which has improved over the past several decades. However, more efforts should be made to improve early diagnosis, the surveillance of patients who undergo resection and treatment for metastatic RCC. Recently, small non-coding RNAs (microRNAs) were found to play pivotal roles in the metastatic dissemination of tumor cells in different types of cancer. The aim of this review is to provide an overview of the role of microRNAs in the pathogenesis of RCC and to discuss their potential as diagnostic, prognostic and, ultimately, therapeutic biomolecules.