OBJECTIVE: To summarize the experience of transabdominal approach radical nephrectomy for giant kidney cancer (tumor diameter ≥12 cm). METHODS: Forty-five patients with giant kidney cancer were admitted from May 2002 to May 2009. A subcostal oblique incision was chosen for the transabdominal approach, and a liver puller was used to reveal the operative field; the renal artery was first ligated to block the renal blood supply and then the non-tumor side tissue was freed; minimally invasive techniques (such as titanium clamps and Hem-o-lock) were applied during the separation of the tumor; when a cancerous thrombus was encountered in the inferior hepatic vena cava, the vena cava surrounding the cancerous thrombus was blocked with a heart ear clamp and the thrombus was removed. Retrospective summary of operative time, intraoperative complications, estimated intraoperative bleeding, postoperative hospitalization time, and postoperative pathology.