This chapter describes the surgical procedure of a nephrectomy, or nephroureterectomy, as performed by the following approaches: open abdominal surgery and laparoscopic. This chapter also describes the alternative procedure of a laparoscopic nephron-sparing resection of a renal mass, which could also be performed with an open approach. The text includes an introduction that outlines the indications, risks, alternatives, essential steps, needed equipment, and variations in technique for the procedure in question. This introduction is followed by a template operative dictation for each approach, that provides the reader with an operative report, such as is found in a patient chart or electronic medical record. A description is provided of the following critical concepts for this/these procedure (s): positioning, removal of the kidney/tumor, including the ureter with the specimen, as well as lymph node sampling, and strategies to avoid vascular injury.