Background Few reports have focused on renal cell carcinoma (RCC) in the people with HIV(PWH). Methods We analyzed patients diagnosed with RCC at our center between January 2011 and June 2024, divided into groups based on their HIV status. Categorical variables were compared using the chi-square test, and continuous variables were analyzed with the t-test. We estimated median and 1-, 3-, and 5-year cancer-specific survival (CSS) using Kaplan-Meier curves and conducted univariate and multivariate Cox analyses to evaluate variables associated with CSS. Results In total, 144 RCC patients were assigned to either PWH group (n = 48) or PWoH (people without HIV) group (n = 96). Patients in the PWH group were significantly more likely to be male (91.7% vs. 71.8%, p = 0.014), and their median age was 7 years younger than that in the PWoH group (51 vs. 58 years, p < 0.01). Both groups had small-diameter, early-stage, low-grade tumors, with no significant differences in short-term outcomes. Higher tumor stage (> T1 vs. T1: hazard ratio = 8.621, 95% confidence interval = 3.76-20, p < 0.01) and larger tumor diameter (>= 7 vs. <7 cm: hazard ratio = 3.525, 95% confidence interval = 1.697-7.321, p < 0.01) were significantly associated with CSS, whereas the HIV status did not significantly affect long-term survival. Conclusions RCC tends to be diagnosed at a younger age in PWH, highlighting the need for earlier RCC screening in this population. The HIV status does not affect postoperative recovery, short-term outcomes, or long-term survival in patients with RCC.