Renal oncocytomas almost uniformly have a benign course, and nephron-sparing surgery (NSS) is the favored treatment. However, a total nephrectomy is usually performed for most oncocytomas because of the difficulty in differentiating them from renal cell carcinoma (RCC). We present a 44-year-old male with a 6-cm centrally located right renal tumor. A hand-assisted laparoscopic radical nephrectomy was performed, and an oncocytoma was revealed by the pathology report. The postoperative course was smooth, except for the development of renal insufficiency. The diagnosis and management of renal oncocytomas are reviewed and discussed.