Objective To compare the tumor and renal function outcomes of patients with localized renal cancer at least 10 years after laparoendoscopic single-site radical nephrectomy (LESS-RN) or conventional laparoscopic radical nephrectomy (CL-RN). Methods Totally 31 pairs of T1a-T2a localized renal cancer patients treated with LESS-RN or CL-RN in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) during 2009-2012 were matched by age, body mass index, and tumor size. Baseline characteristic, surgical data, pathological results, and follow-up information were analyzed to evaluate the long-term outcomes between the 2 groups. Results There were no significant differences between the LESS-RN and CL-RN groups in operative time (［179.7±43.0］ min vs ［172.6±50.9］ min, P＝0.349), estimated blood loss (100［50, 200］mL vs 100［50, 150］mL, P＝0.871), or hospital stay (6［5, 7］d vs 7［6, 9］d, P＝0.080). Only 1 intraoperative complication occurred in both groups, while no postoperative complication occurred in the LESS-RN group and 3 in the CL-RN group. The follow-up time was (138.0±9.0) months in the LESS-RN group and (137.8±9.8) months in the CL-RN group (P＝0.730). The overall survival rate (80.6% vs 74.2%, P＝0.181), cancer-specific survival rate (93.6% vs 96.8%, P＝0.554), change in creatinine level (32 ［17, 45］ μmol/L vs 20［5, 47］μmol/L, P＝0.098) or estimated glomerular filtration rate (［60.2±20.9］mL·min^-1· (1.73 m²)^-1 vs［66.7±27.8］mL·min^-1·(1.73 m²)^-1, P＝0.342) were not significantly different between the 2 groups. Conclusion LESS-RN is a safe and feasible surgical method for localized renal cancer with long-term tumor efficiency and renal function outcomes comparable to CL-RN.