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Background: The past decades have significantly changed the diagnosis and management of kidney tumors. There is a growing trend for a less invasive therapeutic approach. The study seeks to present our experience with a number of patients who underwent percutaneous ultrasound (US)-guided radiofrequency ablation (RFA) of renal masses. Material/Methods: From July 2002 to December 2006, RFA was carried out in 55 selected patients with an enhancing kidney tumor on computed tomography (CT). The procedure was performed under conscious sedation. The patients were at risk for surgery or had a remaining kidney. Monopolar Cool-tip Tyco or bipolar Celon Olympus RFA devices under US-guidance (convex 3.5 MHz) were used. Abdominal 3-phase multi-slice computed tomography (MSCT) was performed 3, 6 and 12 months post RFA and once yearly thereafter. Results: At a mean follow up of 25 months (range, 6-53 months), 52 of the 55 tumors showed no contrast enhancement on CT. Three incompletely ablated tumors were successfully treated with the second RFA. There were no major complications in any procedure and intervention was well tolerated. So far we have observed one metastasis to a homolateral adrenal gland which was revealed on MSCT. Conclusions: Percutaneous RFA is a minimally invasive technique which appears to be a promising alternative for patients with small renal tumors. 3-phase MSCT improves the imaging of renal masses, enabling not only optimal treatment planning but also a reliable monitoring of tumor destruction after RFA.