Background: Pazopanib is an oral multi targeted tyrosine kinase inhibitor that has been approved for first-line treatment of metastatic Renal Cell Carcinoma (mRCC). This trial aimed to investigate the real-life clinical outcomes of the first-line pazopanib in Egyptian patients with mRCC. Patients and Methods: Data from 30 patients with mRCC, treated with pazopanib at our institutions during the period from January 2016 to December 2018, were analyzed retrospectively. All patients received 800 mg/day pazopanib. The primary end point was Progression-Free Survival (PFS). Secondary end points included overall survival, tumor response rate, and safety. Results: Thirty patients were included 23 (76.7%) male and 7 (23.3%) female, of median age 53 years (range, 20-76 years). Clear cell pathology was reported in 80%. Lung and Lymph nodes were the most common sites of metastasis 53.3%, 46.7 respectively. Most AEs were grade 1/2, Diarrhea (33.3%), hypertension (26.7%), and stomatitis (23.3%) were the most common AEs reported while thrombocytopenia was the most common hematological toxicities. The median PFS was 9 months (95% CI 7.12-10.87) and the median OS was 28 months. The estimated 2-year survival rate was 57%. The objective response rate was 30%. Conclusion: This study proved that pazopanib treatment has clin