Percutaneous ablation may be a reasonable option for patients in whom a major surgical procedure is undesirable or contraindicated. Potential advantages of percutaneous ablation include its low invasiveness, short procedural and recovery time, low complication rate, short hospital stay, maximal renal function preservation, and lower costs in comparison to surgical resection. Indications for ablative techniques include incidental small cortical masses in older patients with high surgical risk, patients who have hereditary syndromes with an increased risk of developing multifocal tumors, patients with a solitary kidney, patients with chronic kidney disease, and patients who do not want to undergo a major surgery. Tumors most amenable for percutaneous ablation are small and located in the posterior cortex. Although the informed consent process can be onerous, it is of the utmost importance before any procedure, including percutaneous ablation of renal masses. It is a fundamental instrument for the protection of patients and physicians.