Objective To compare the efficacy of laparoscopic radical nephrectomy(LRN) and open radical nephrectomy(ORN) for clinical stage T2 renal cell carcinoma. Methods A total of 138 patients underwent radical nephrectomy for renal cell carcinoma, including 63 by LRN and 75 by ORN. Renal cell carcinoma was pathologically confirmed in all the patients. The patients were followed up for 5-36 months, with a median of 24 months. The surgical blood loss, operation time, and time of starting food postoperatively, and hospital stay were compared between the two groups. Results The operation time was 90-385 min (a mean of [213±61.6] min) for LRN and 55-320 min (a mean of [173±52.3] min)for ORN (P=0.000). The blood loss was 30-1 600 ml (a mean of [220±291.8] ml) for LRN and 50-1 400 ml (a mean of [319±244.1] ml) for ORN (P=0.032). The fasting period of surgery was 1-4 d (a mean of [2.4±0.82] d) for LRN and 2-5 d (a mean of [3.1±1.02] d) for ORN(P=0.000).The hospital stay was 4-15 d (a mean of [7.3±2.50] d) for LRN and 6-15 d (a mean of [9.3±2.25] d) for ORN (P=0.000). Conclusion The efficacy of LRN is similar to that of ORN. LRN has the advantages of minimal invasiveness and rapid postoperative recovery. The complication of LRN is similar to ORN, and it might be an alternative treatment for clinical T2 stage renal cell carcinomas.