Renal cell carcinoma (RCC) accounts for 400,000 new cases and over 170,000 deaths globally each year. Skeletal metastases from RCC are common, occurring in about 21% of cases, and are associated with a poorer prognosis compared to other metastatic sites. RCC bone metastases can lead to significant morbidity due to complications such as pain, hypercalcemia, and pathological fractures. Management of bone metastases from RCC involves treating the systemic disease with receptor tyrosine kinase inhibitors (RTKIs) and checkpoint inhibitors (CPIs), which have improved overall outcomes in these patients. Additionally, directed therapies, like surgery or radiation, are vital for alleviating skeletal complications. Supportive measures, like bisphosphonates and denosumab, help manage bone health but carry risks like osteonecrosis. A multidisciplinary approach is essential for optimizing outcomes, with ongoing research needed to enhance therapies for skeletal metastases and further improve patient quality of life.