Nowadays, the minimally invasive treatment of symptomatic renal cyst has been progressively gaining wide acceptance while classic open surgery has been almost abandoned. It is a still controversial which minimally invasive approach provides the major advantages and results. Fifty-two patients with symptomatic simple renal cyst underwent ultrasound guided percutaneous drainage and sclerotherapy (ethanol 95 degrees) and 20 patients underwent laparoscopic unroofing of simple renal cysts in our department. No major complication was recorded with both the techniques. Even if we reported a higher recurrence rate (82%) with sclerotherapy than that with laparoscopic treatment (5%) we consider the percutaneous drainage a valid approach because it is a safe, easy and at low cost procedure.