The motives for performing conservation surgery in tumors of the upper urinary tract are progressive renal failure associated with those tumors, frequent bilateral tumors, and tumors on solitary kidney, which does not always comply with the patho-anatomic characteristics of the tumor and possibilities of this type of surgery. The aim of the study was to separate the real indications for the application of this therapy, independently of the expected quality of life after the operation. Out of 682 patients with upper urothelial tumor conservation surgery was performed in 161 patients. The indications were characterized as "real", oncologic in 121 patient, and in 40 patients (25%) the main reason was preservation of quality of life. During the five-year follow-up period recurrence developed in 17% of patients in the group with oncologic indications, "real" indications, and in as much as 40% of patients from the group in with the main reason was preservation of quality of life. Thus, the oncologic indications must be primary in reaching the decision for conservation surgery in tumors of the upper urinary tract, and the quality of life should be an additional motive for this therapy.