Abstract: Objective To investigate the effect and safety of Sorafenib in treatment of middle aged and elderly patients with metastatic renal cell carcinoma． Methods Clinical efficacy of Sorafenib in 20 patients diagnosed with metastatic renal cell carcinoma in our hospital from October 2006 to April 2012 were ascertained． Results Of the 20 patients, 17 were male, and 3 were female, with a median age of 61 years (range from 45 to 83 years) and an average follow-up time of 40 months． CR was achieved in 1 case (5．0%), PR in 5 cases (25．0%), SD in 14 cases (70．0%), and PD in 6 cases while these cases were all dead． The objective response rate (ORR) was 30．0% (6/20), and the clinical benefit response rate (CBR) was 65．0% (13/20)． The progression-free-survival (PFS) was 46．1 (95% CI: 35．8-56．4) months． Conclusion There is a favorable efficacy for Sorafenib in treatment of middle aged and elderly patients with metastatic renal cell carcinoma．