Objective To evaluate the safety, feasibility and efficacy of da Vinci robot-assisted laparoscopic partial nephrectomy in the treatment of renal tumors with PADUA score of ≥10, and assess its clinical role. Methods Between May 2012 and September 2013, 37 cases of da Vinci robot-assisted laparoscopic partial nephrectomy for renal tumors with PADUA score of ≥10 were performed a single urologist at our institution. Patient age 52.3±10.1(32-72)years; Body mass index 24.9±3.88(17.1-34.3) kg/m2; Charlson Co-morbidity Index (Age-weighted) 0.5±0.84(0-3); Tumor laterality (L/R) 20/17; all tumors were unilateral and solitary lesions with a mean diameter of 4.2±1.19(2.1-7.2)cm and PADUA score of 10.8±0.87(10-13); Preoperative eGFR (mL/min•1.73m2) 101.2±25.58(46.6-198.7). The renal pedicle, involved kidney, tumor exposure, tumor excision and renorrhaphy were conducted with da Vinci robot-assisted laparoscopic techniques. Results All 37 cases were smoothly finished without any surgical conversion, intraoperative complications or transfusion. Operative time was 241±50.0(120-330) min, estimated blood loss was 185±169.9(50-1000) ml, renal ischemia time was 26.7±9.90(0-50) min. The mean postoperative stay was 11.4±3.44(8-19) days with an overall complication rate of 13.5%(5/37). Pathological examination revealed none of positive surgical margin, 28 cases of renal clear cell carcinoma, 3 papillary cell carcinoma, and 5 different types of benign lesions. At a mean follow-up of 5.9±4.64(1-12) months, all patients are alive and no local recurrence or distant metastasis were detected. Nevertheless, the estimated glomerular filtration rate decreased at a mean percentage of 8 and before-after comparison revealed significant difference(Z=-2.883, p=0.004). Conclusion da Vinci robot-assisted laparoscopic partial nephrectomy provides a meticulous alternative in the surgical management of high PADUA score renal tumors with minimally invasiveness, improved safety, and renal function preservation, although the cancer control outcomes are awaited further follow-up.