The opening session of the 2024 Belgian Multidisciplinary Meeting on Urological Cancers (BMUC) highlighted key advancements in renal cell carcinoma (RCC) management. Prof. Christine Gennigens (ULiège, Liège, Belgium) presented current and future strategies for first-line metastatic RCC treatment, emphasising options such as immunotherapy (IO) dual combinations, IO plus tyrosine kinase inhibitor (TKI) regimens, TKI monotherapy, and triplet therapies. Additionally, Prof. Shankar Siva (Peter MacCallum Cancer Centre, Melbourne, Australia) discussed the promising outcomes of stereotactic ablative body radiotherapy (SABR) in primary RCC, underscoring its advantages over traditional approaches like surgery or thermal ablation.