Purpose: Kidney cancer mortality in the United States exhibits persistent racial, ethnic, and geographic disparities, yet regional patterning of these disparities over time remains incompletely characterized. We conducted a retrospective analysis using national mortality data to examine differences in kidney cancer mortality between U.S. Mexico border and non-border regions from 2000 through 2020. Materials and Methods: Death records were obtained from CDC WONDER, and kidney cancer deaths were identified using ICD 10 code C64 as the underlying cause of death. We evaluated C64 to C65 in sensitivity analyses, including C65 separately. We compared demographics, age adjusted mortality rates, and temporal trends by border residence. Multivariable logistic regression assessed demographic patterning of deaths across regions, and Joinpoint regression evaluated changes in age adjusted mortality trends over time. Results: A total of 279,117 kidney cancer related deaths were recorded nationally. Hispanic decedents were disproportionately represented among border state deaths (22.9% vs 2.8% in non-border states). Border states accounted for 67.4% of Hispanic C64 deaths. Age distribution and racial composition of decedents differed between border and non-border regions (all p<0.001). In multivariable analyses, Hispanic ethnicity was strongly associated with border state residence among decedents, independent of age and race. Joinpoint regression identified multiple periods of change in mortality trends, with statistically significant increases in non-border regions and less precise segment estimates in border regions. Conclusion Kidney cancer deaths among Hispanic decedents show substantial geographic concentration in U.S. Mexico border states. These findings support surveillance strategies and interventions that incorporate geographic context in efforts to reduce kidney cancer mortality disparities.