Objective To investigate the clinical outcomes of transperitoneal and retroperitoneal approach in laparoscopic nephrectomy for large renal tumors. Method :62 cases undergoing eradication operation in our hospital were divided into observation group (40 cases, retroperitoneal approach) and control group (22 cases, transperitoneal approach). The operation duration, bleeding volume,  complication occurrence rate, ICU, being hospital time and hostaligical results were determined. Results: The operation time of observation group was significantly lower than that of control group (P<0.05), while no significant difference was found in bleeding volume, complication occurrence rate, ICU, being hospital time (P>0.05). There were 33 cases of clear-cell tumor, 5 cases of papillary rental cell carcinoma and 2 cases of chromophobe rental cell carcinoma in observation group; 19 cases of clear-cell tumor and 3 cases of papillary rental cell carcinoma in control group. No positive surgical margins were found. Control group showed higher T stage, with significant difference (P<0.05). There was no significant difference between occurrence rate, and average lifetime (P>0.05). Conclusion :Laparoscopic nephrectomy was feasible to treat large renal tumors (>7 cm) for doctors with rich experience. Transperitoneal and retroperitoneal approach in laparoscopic nephrectomy showed different features and the approach choice should made on the basis of precise evaluation on specific situation.