Kidney cancer is one of the ten most common malignant neoplasms. The disease can be local or metastatic. Locally limited disease has a significantly better prognosis than the metastatic one. With the development of radiological tests, the diagnosis is more often made in the local disease stage. The most common histological type of renal cell carcinoma is clear cell (ccRCC), and the second most common are papillary and chromophobe. The stage of the disease is determined according to the TNM classification. Before starting the treatment of metastatic disease, the risk level for the patient should be identified, and MSKCC and IMDC models are used for this purpose. Basic treatment methods for metastatic disease are: surgical treatment, systemic therapy and radiotherapy. The following surgical procedures are used: cytoreductive ephrectomy, lymphadenectomy and metastasectomy. Treatment with systemic therapy did not provide results before because kidney cancer is a chemo-resistant tumour. By developing new drugs, better treatment options were created. Drug groups used in systemic therapy nowadays include: checkpoint inhibitors (immunotherapy), tyrosine kinase inhibitors, mTOR inhibitors and monoclonal VEGF antibodies. The best therapeutic options are checkpoint inhibitors and tyrosine kinase inhibitors. Current treatment guidelines for first-line treatment of metastatic clear cell kidney cancer propose using dual immunotherapy or combined immunotherapy with tyrosine kinase inhibitor. Side effects are common when using these drugs, but they are often considered biomarkers of therapeutic response. Radiotherapy has a role primarily in palliative treatment of metastases. By implementing immunotherapy most commonly in the first, and less often in second line of treatment of patients with metastatic kidney cancer, approximately 15% of patients can be fully cured. Treatment of metastatic kidney cancer remains extremely demanding. Treatment requires regular monitoring of the patient and a multidisciplinary approach.