Renal cell carcinoma (RCC) is a biologically and clinically heterogeneous malignancy arising from the renal tubular epithelium, encompassing multiple histological and molecular subtypes with distinct prognostic and therapeutic implications. Advances in molecular oncology have substantially improved the understanding of RCC pathogenesis, particularly regarding dysregulation of the VHL-HIF axis, angiogenic signaling, immune escape mechanisms, and metabolic reprogramming. These insights have driven a paradigm shift from cytokine-based therapies toward targeted agents and immune checkpoint inhibitors, leading to meaningful improvements in patient outcomes, especially in advanced disease. This chapter provides an integrated overview of RCC, spanning epidemiology, risk factors, histopathological classification, and contemporary management of localized and metastatic disease. Emphasis is placed on the evolving role of precision medicine, including the identification and clinical application of prognostic and predictive biomarkers through multiomics approaches such as genomics, transcriptomics, proteomics, metabolomics, and single-cell analyses. Emerging therapeutic strategies targeting hypoxia-inducible factors, novel immune checkpoints, and the tumor microenvironment are also discussed. Additionally, the potential clinical impact of circulating tumor DNA, the gut microbiome, and artificial intelligence-based tools in diagnosis, risk stratification, and treatment selection is examined. Overall, RCC exemplifies the translational integration of biological complexity into personalized oncologic care, underscoring the need for biomarker-driven clinical trials to further optimize individualized treatment strategies.