INTRODUCTION: Laparoscopic renal cyst decortication has become the standard of care for management of large symptomatic simple renal cysts. The aim of the present case report is to present such a case in an ambulatory setting. CASE REPORT: A 41-year-old woman presented with a 3 year history of a painful 9 cm x 7.3 cm right lower pole simple renal cyst. Laparoscopic renal cyst decortication was performed through three 5 mm trocars. The operating time was 145 minutes. There were no intraoperative or postoperative complications. The wounds were infiltrated with a total of 20 cc of 0.25% Marcaine. At the end of the procedure, she also received 1.3 g of acetaminophen rectally and 30 mg of ketorolac intravenously. The patient remained in the recovery room for a total of 3 hours. She was hemodynamically stable and was able to ambulate right away. She was discharged home directly from the recovery room and remained pain free on subsequent follow ups at 3 days and 1 month. COMMENTS: The present case report is a new trend in the laparoscopic management of renal cysts whereby patients can be treated in an ambulatory setting. This would make laparoscopic management even more advantageous when compared to percutaneous drainage and sclerotherapy. In an era of increasing health care costs, performing such cases in an ambulatory setting provides cost effective management in patients who are compliant.