Objective To analyze the clinicopathological and immunohistochemical characteristics of renal cell carcinoma (RCC) bone metastasis, and to explore the pathological characteristics and high-risk factors of bone metastasis in RCC patients. Methods A retrospective study was conducted on the clinicopathological and immunohistochemical characteristics of 1 694 RCC patients without bone metastasis and 133 RCC patients with bone metastasis, who were admitted to Changzheng Hospital of Naval Medical University (Second Military Medical University) from Jan. 2012 to Dec. 2017. The paired pathological data of primary and bone metastatic lesions were analyzed in 25 RCC patients whose primary and bone metastatic lesions were removed successively or simultaneously in Changzheng Hospital. Results Compared with the RCC patients with bone metastasis, the proportion of males was significantly lower in the RCC patients without bone metastasis (70.1%[1 188/1 694] vs 84.2%[112/133], P<0.01), and the proportion of clear cell RCC (CCRCC) patients was also significantly lower (83.4%[1 412/1 694] vs 93.6%[103/110], P=0.004). Fuhrman nuclear grade Ⅲ/Ⅳ accounted for 17.7% (247/1 398) and 51.6% (32/62) in the CCRCC patients without bone metastasis and with bone metastasis, respectively, and the difference was significant (P<0.001). The proportion of the patients having tumor invasion or breakthrough of the renal capsule was 44.0% (11/25) in the 25 patients with bone metastasis having matched data and 18.9% (320/1 694) in the RCC patients without bone metastasis, and the difference was significant (P=0.002). Matching analysis showed that the Ki-67 marker index was significantly lower in the primary lesions than that in the bone metastatic lesions (median[lower quartile, upper quartile]:5.0%[2.0%, 6.0%] vs 6.0%[3.0%, 15.0%], P<0.001). Conclusion CCRCC is more prone to bone metastasis than non-CCRCC. Male, Fuhrman grade Ⅲ/Ⅳ and invasion of renal capsule are high risk factors of bone metastasis. The Ki-67 marker index is higher in bone metastatic lesions than that in primary tumor, suggesting that the pathological characteristics of primary and bone metastatic lesions are not identical and the pathological analysis may guide treatment.