Renal cell carcinoma is one of the most common malignant tumors of the urinary system, accounting for the second highest incidence of urological tumors and 2% of systemic malignancies. Statistics show that about one-fourth of patients with renal cell carcinoma have metastasis by the time they are detected. At present, the treatment of renal cell carcinoma is still mainly based on radical surgery, but the recurrence rate after surgery is more than 20%, and the effect of radiotherapy and chemotherapy is poor. Studies have shown that the emergence of molecular targeted therapy for tumors offers the possibility to solve this problem. Recent studies on the molecular biology of renal cell carcinoma have revealed that renal clear cell carcinoma (which accounts for more than 75% of renal cell carcinoma) has a very high rate of VHL gene mutation. Mutations in this gene can cause abnormalities in the signaling mechanism of the cellular tissue hypoxia response. Genes induced by this mechanism include vascular endothelial growth factor (VEGFR), platelet-derived growth factor (PDGFR), transforming growth factor alpha and carbon dehydratase IX, which provide potential new targets for molecularly targeted therapy in this disease. Sorafenib has dual anti-tumor effects. On the one hand, it can directly inhibit tumor growth by inhibiting RAF/MEK/ERK signaling pathway; on the other hand, it can indirectly inhibit tumor cell growth by blocking the formation of tumor neovascularization by inhibiting VEGFR and PDGFR. Another multi-target drug, Sunitinib, which targets VEGFR, PDGFR, FLT-3, and KIT, has been shown to be clinically beneficial in two phase II trials for the treatment of refractory metastatic renal cell carcinoma, with minimal toxic effects. The first trial included all tissue subtypes of renal cell carcinoma and had an objective efficacy rate of 40 percent. The second trial limited enrollment to patients with clear cell carcinoma who had undergone nephrectomy. Advances in understanding the natural history and molecular genetics of renal cell carcinoma have led to a paradigm shift in the treatment of renal cell carcinoma. A new generation of targeted therapeutic agents has shown great advantages and achieved exciting efficiency rates, and multi-targeted agents such as sorafenib are expected to prolong progression-free survival in patients with advanced renal cancer.