Objective To study the expression of eukaryotic elongation factor 1A1 (eEF1A1) in T₁N₀M₀ renal cancer tissues and its relationship with patient prognosis. Methods The tissue specimens of patients with renal cell carcinoma who received radical nephrectomy in Shanghai Changhai Hospital in 2007 were collected. Inclusion criteria were: no treatments before surgery, T₁N₀M₀ stage, clear cell carcinoma and with complete follow-up data. Immunohistochemical staining was used to examine the expression of eEF1A1 in the cancerous tissues, and we then established the relationship of eEF1A1 expression with Fuhrman pathological grading and patient prognosis. The relationship between Fuhrman grading pathological staging and eEF1A1 expression was investigated by drawing crosstabs, chi-square test, and Fisher's exact test. Kaplan-Meier survival curves and log-rank test were used to study the relationship between eEF1A1 and prognosis of patients with T₁N₀M₀ renal cell carcinoma. Results The patients were followed up for 4-95 months, averagely (77.9±18.3) months; the overall survival rate of patients was 88.6% and the progression-free survival rate was 80.0% during the follow-up period. Immunohistochemistry showed eEF1A1 was highly expressed in 61.4% of renal cell carcinoma tissues and in tissues of high Fuhrman grade (P=0.004). Survival analysis showed patients with low expression of eEF1A1 in renal cell carcinoma tissue had significantly longer survival (P=0.019), and all the patients with low expression survived in our study. Conclusion Expression of eEF1A1 in T₁N₀M₀ renal cell carcinoma tissue is associated with Fuhrman grades and prognosis, with low expression indicating a better prognosis.