Histotripsy is a noninvasive, ultrasound-based tissue focused technique that uses focused high-intensity sound waves to mechanically fractionate tissue without causing thermal damage. Initially explored in preclinical studies, histotripsy has shown promising results in various solid tumor models, demonstrating its potential as an effective treatment option for oncological conditions. The technique works by creating microbubbles within the targeted tissue, leading to mechanical disruption and cell death while minimizing harm to surrounding healthy structures. This makes histotripsy particularly advantageous for tumors located near critical anatomical structures or in patients for whom traditional surgical methods are not viable. Early in vitro and in vivo studies have reported promising outcomes, including successful tumor reduction and improved survival in animal models. However, the translation of these findings into clinical practice is still in progress. Ongoing clinical trials aim to determine the safety, efficacy, and long-term outcomes of histotripsy in the treatment of primary solid renal tumors. These trials will help define optimal treatment protocols, identify ideal patient populations, and explore potential combinations with other therapies. As clinical evidence continues to emerge, histotripsy is expected to become a valuable noninvasive alternative for treating solid tumors, including RCC. It holds particular promise for patients with tumors in challenging locations or those who are poor candidates for conventional interventions.