Renal injuries may occur during various procedures (iatrogenic) or because of external violence (blunt or penetrating). Early diagnosis and immediate repair are the key factors in management of iatrogenic renal injuries. In suspected renal trauma the best radiological diagnostic tool is contrast enhanced computerized tomography. The most popular injury scaling system is the one of the AAST (based on CT findings). Most renal injuries are successfully managed nonoperatively, and the rate of nephrectomies is declining over the years. Hemodynamic stability is the basic criterion for selection of the mode of management. Stable patients are selected for nonoperative treatment while unstable patients who don’t respond to resuscitation are considered candidates for surgical exploration. Selective arterial embolization is a useful tool for hemorrhage control. Associated intraabdominal injuries should be managed simultaneously. Exploration when the trauma patient is unstable is a lifesaving operation, while preservation of the renal unit should be attempted if possible (renorrhaphy and partial nephrectomy). Most of the complications can be treated conservatively or with minimal invasive techniques.