Abstract: Objective To compare the clinical efficacy on retroperitoneoscopic nephron sparing surgery (RPNSS) and retroperitoneoscopic radical nephrectomy (RPRN) for stage T1bN0M0 renal cell carcinoma (RCC). Methods Clinical data about T1bN0M0 RCC patients who received RPNSS (n=16) and RPRN (n=40) in our hospital from January 2009 to July 2013 were retrospectively analyzed. The operative time, intraoperative blood loss, postoperative blood transfusion rate, postoperative complications, drainage days, long-term renal function, local recurrence and distant metastasis rates of the two groups were observed and compared. Results The difference of two groups was statistically significant in the operative time and intraoperative blood loss (P< 0.05). However, no significant difference was found in postoperative blood transfusion rate, postoperative complications, drainage days, long-term renal function, local recurrence and distant metastasis rates. Conclusion As for patients with T1bN0M0 renal cell carcinoma, the clinical efficacy of RPNSS is reliable with less side effects on renal function in patients. Compared with RPRN, RPNSS has similar effects on long-term renal function, local recurrence and distant metastasis rates.