With the improvement of people’s health awareness and the updating of imaging equipment, patients with small renal tumors are increasingly being detected during physical examinations. Small renal tumors generally refer to substantial renal masses with a maximum diameter of ≤4 cm, which can also be called incidental tumors. There are more treatment options for small renal tumors. Therefore, patients are often at a loss when choosing between these treatments after consulting several specialists. Now, we would like to summarize the frequently asked questions about small renal tumors. 1. Are small renal tumors always malignant? Most of the small renal tumors are asymptomatic at the time of discovery, but according to the more and more advanced CT or magnetic resonance technology, as well as the experience of imaging doctors and urologists, they can be basically judged to be benign or malignant. However, there are about 10-20% of small renal tumors that are considered malignant before surgery and the pathological results are benign after resection. 2.What is the optimal treatment plan for small renal tumors? Kidney-preserving surgery, i.e. removing the tumor and a little normal kidney tissue around the tumor, preserving most of the kidney tissue and maintaining kidney function. 3.Can all small kidney tumors undergo kidney-sparing surgery? It should be decided according to the location of the tumor in the kidney. The adjacency of the tumor to the large blood vessels in the kidney is the main factor in determining whether kidney-sparing surgery can be performed. Of course, it is also directly related to the level and experience of doctors. 4, choose open or laparoscopic kidney preservation surgery? Kidney preservation surgery is one of the biggest surgeries in urology. Whether it is open, or minimally invasive laparoscopic kidney preservation surgery, it requires high level and enough experience of doctors. There is no difference between open and minimally invasive surgery in terms of the effectiveness of tumor treatment and protection of kidney function. 5.Are there other treatments for small kidney tumors? At present, there are also radiofrequency or cryotherapy for small kidney tumors in the international arena. However, kidney preserving surgery is still the most reliable method to treat small kidney cancer. At present, a few hospitals in China have carried out radiofrequency treatment for renal tumors, but the therapeutic effect has to be confirmed by large clinical trials. 6.Can small kidney tumor be treated without surgery? For those patients whose physical conditions are not suitable for surgery and may have serious comorbidities with high risk of surgery, regular review is available.