Abstract: The surgical treatment of renal cell carcinoma (RCC) with concurrent Mayo Ⅲ-IV inferior vena cava tumor thrombus presents significant challenges due to the necessity for hepatic portal vasculature and inferior vena cava occlusion to facilitate tumor thrombus removal. Circulatory bypass techniques, such as cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA), afford the establishment of alternative circulatory routes to maintain regular systemic circulation and protect vital organs, thereby ensuring surgical safety. Nevertheless, potential complications, including bleeding and neurological dysfunction, limit the application of CPB and DHCA. This article provides a review of the advancements in surgical treatment of renal carcinoma with inferior vena cava thrombus using bypass techniques epitomized by CPB and DHCA, and discusses their complications and corresponding management strategies.