Noninvasive, extracorporeal radiosurgery for renal tumors is the next logical progression in the field of minimally invasive and percutaneous ablative therapies. Renal radiosurgery is a delicate, highly complex procedure wherein the surgeon in partnership with the radiation oncologist employs sophisticated equipment to plan and execute a radiosurgical treatment plan. Due to the high dose of radiation delivered per fraction, accuracy and precision are critical in radiosurgery to avoid toxicity to surrounding tissues. With the kidney, tumor motion must be accounted for during treatment planning and delivery to ensure safe and effective therapy. This chapter focuses on the general principles of radiosurgical planning, instrumentation, patient positioning, and radiation delivery for the treatment of renal masses. We also provide detailed step-by-step technical instructions and offer practical tips and tricks.