The methods, indications, results, and complications in fine-needle puncture of the kidneys are discussed, with particular attention to cysts that have an atypical appearance in tomographic procedures. The problems of percutaneous cyst treatment and the possibilities of abscess therapy by fine-needle puncture are presented. The limited indications of using this method in solid kidneys tumors are defined, and antegrade pyelography and the differentiation of perirenal processes are discussed.