Axitinib, an oral small-molecule tyrosine kinase inhibitor targeted to angiogenesis, has demonstrated activity in advanced renal cell carcinoma. Common side effects include hypertension, fatigue and dysphonia. Axitinib is currently awaiting approval as a second-line agent in the treatment of advanced renal cell carcinoma. Trials, which include treatment-naive patients, are ongoing and will study the benefit of axitinib in the first-line setting.