The modern era of renal surgery began on August 2, 1869 when the first planned nephrectomy on a living human being was performed. Eighteen years later in 1887, the first partial nephrectomy to remove a renal tumor was performed. Both total and partial nephrectomy have become the hallmark surgical procedures used today to treat renal tumors, and their conception and evolution represent two of the most important advances in medicine and surgery. Surgery for kidney cancer continues to evolve. This article traces the history of surgical management for renal tumors.