A retrospective analysis of all primary upper urinary tract tumours (300) filed in the pathology department of a regional hospital in Hong Kong during 1972-87 showed that renal cell carcinoma (143) was the commonest malignant tumour. Transitional cell carcinoma of the renal pelvis (62) was the next most frequent. Fibromas, which occurred as frequently as angiomyolipomas (28) and outnumbered tumours such as squamous cell carcinoma (13) and nephroblastoma (12), were of little clinical significance since they were invariably incidental findings. Nephrectomies were seldom performed for kidneys involved in secondary malignancies. Rare tumours encountered were adenocarcinoma of the renal pelvis, leiomyosarcoma, malignant fibrous histiocytoma, adenoma, oncocytoma, mesoblastic nephroma and multilocular cystic nephroma. Angiomyolipomas were responsible for most cases of surgical emergency.