Objective To summarize the diagnostic and therapeutic experience of advanced renal tuberculosis , so as to in-crease diagnostic accuracy and therapeutic efficacy of advanced renal tuberculosis .Methods Clinical data of 43 cases of medium or advanced renal tuberculosis admitted into our Department from January 2005 to January 2012 were analyzed retrospectively .Results Irritation signs of bladder , gross hematuria , and lumbodynia were the most commonly-seen symptoms of advanced renal tuberculosis , with incidence rates being 81.4%, 65.1%, and 44.2% respectively.In laboratory detection, acid-fast stains on urinary sediment seemed to have diagnostic value.Medical scanning indicated that the diagnostic accordance rate of CT was the highest (81.4%), and statistical significance could be noted , when compared with ultrasonic examination or KUB +IVU(P<0.05).However, no statistical significance could be seen, when it was compared with MRU(P>0.05).Five cases underwent purely anti-tuberculosis treatment and 2 of the cases improved during medication , but were deteriorated after drug withdrawal .There was one case of autonephrectomy , and 2 cases failed to respond to anti-tuberculosis treatment .Thirty-eight patients underwent surgical treatment , of whom 34 patients underwent nephrectomy , 4 patients underwent nephroureterectomy with bladder cuff .There were 32 cases of open surgery , of which 6 cases under-went laparoscopic surgery .All the 38 cases were cured .Conclusion Urinary tract CT examination has a high diagnostic value for medi-um or advanced renal tuberculosis .Patients with medium or advanced renal tuberculosis mostly required surgical therapy for final cure of the disease.If the contralateral renal function was good , the affected kidney could be removed .And it was not advisable to perform par-tial nephrectomy or percutaneous catheter drainage of tuberculous abscess .