Purpose: Renal injury occurs in up to 5% of trauma cases and the kidney is the third most wounded abdominal organ. The study objective was to analyze clinical characteristics of patients with blunt renal trauma and review the treatment of high-grade blunt renal injuries.Methods: The medical charts of trauma patients who visited Haeundae Paik Hospital between March 2010 and February 2020 were retrospectively analyzed. Data on demographics, injury patterns, clinical presentation, management, and outcomes were analyzed.Results: A total of 68 patients with renal trauma were included in this study. The most common renal injury was Grade III (<i>n</i> = 27, 39.7%). Falling was the predominant mechanism of injury (<i>n</i> = 33, 48.5%), and 23.5% (<i>n</i> = 16) of patients sustained isolated renal trauma. Organ damage related to kidney injury included chest injury (57.4%, <i>n</i> = 39) and abdominal or pelvic content injury (48.5%, <i>n</i> = 33). The overall mortality rate was 2.9% (<i>n</i> = 2). There were 45 cases of high-grade renal trauma (AAST Kidney injury scale Grade Ш-V). There was no statistical difference in the outcomes of high-grade (<i>n</i> = 44, 97.8%) and low-grade (<i>n</i> = 23, 100%) renal trauma patients who received nonoperative treatment (<i>p</i> = 0.511). Variables did not differ significantly, except for the injury severity score which was statistically significantly different between low-grade and high-grade renal trauma patients (<i>p</i> = 0.001).Conclusion: Most patients with traumatic renal injury, even those with high-grade injury, can be managed by nonoperative treatment, and have a good prognosis.