The definitive diagnostic tool in many renal diseases is a renal biopsy, when performed well. Traditionally, it is done safely percutaneously under local anaesthesia with a biopsy needle and with ultrasound or computed tomography (CT) guidance (1, 2). It can be performed surgically as an open biopsy (3) under general anaesthesia and by the transjugular route (4). Kidney biopsy can also be performed laparoscopically. This involves using an endoscope to explore the abdomen and the biopsy needle is inserted through the laparoscope and guided to the kidney with ultrasound. A renal biopsy should be performed after careful evaluation by the nephrologist.