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The conviction that the presence of a renal-cell carcinoma does not require the entire organ to be removed allows new therapeutic methods to be envisaged that involve only local tissue ablation, rather than the complete removal of the organ. The trend toward minimally invasive options in the management of renal tumors has prompted interest in energy-based ablation techniques as a possible alternative to radical or partial nephrectomy in selected patients. Cryoablation, radiofrequency interstitial tumor ablation, microwave thermotherapy, and high-intensity focused ultrasound (HIFU) are among such techniques. HIFU has emerged as the least invasive of the possible tumorablation methods. The present review addresses the current literature on experimental and clinical application of HIFU for extracorporeal thermoablation of renal tumors.