Renal cell carcinoma (RCC) occasionally metastasizes to a variety of regions including bone and liver, but nasal and paranasal sinal metastases are rare. No standard treatment currently exists, because of the small number of cases, so treatment varies for each patient. Sorafenib is a novel small molecular inhibitor of several kinases for malignancy, especially for RCC and hepatocellular carcinoma. We report herein on a case of nasal and paranasal metastatic RCC treated with VEGF targeted therapy (sorafenib) and radiotherapy.