Most often any kidney lesions are primary renal, but sometimes they can be secondary (metastases, lymphoma). Every year renal cell carcinoma tends to a significant increase in the incidence. Today there are many available methods of examination, however difficulties often remain in the differential diagnosis of kidney lesions. The article discusses about the modern possibilities of methods in the identification and assessment of kidney lesions, their role in determining the tactics of patient management and key approaches in imaging characterization of these masses using CT and PET, MRI and CEUS. The analysis of the modern literature has shown that the currently existing radiation diagnostic methods do not provide an absolute opportunity for differential diagnosis of rare kidney tumors. CEUS, according to various authors, demonstrates high efficiency indicators, but does not exceed these indicators in comparison with CT and MRI. Contrast-enhanced ultrasound is a potentially safe method and can be used as a method for additional examination to characterize indeterminate renal lesions.