New clinical data and a growing interest in cryobiology are changing the best-practice treatment paradigms for prostate and renal disease. Recent published evidence and documented advances in cryoablative technology have allowed more efficient freezing of the prostate gland while minimizing damage to surrounding tissues, including the rectum, urethra, and external urinary sphincter. The new developments include transrectal ultrasound (TRUS) guidance, urethral warmers, liquid nitrogen (LN2) to gas-driven probes, and smaller cryoneedles. The result is that morbidity associated with this minimally-invasive therapy now rivals that of other treatment options, such as radiation and radical prostatectomy (RP). This program explains the history, evolution, and current best practice in prostate and renal cryoablation, including the equipment used for performing these procedures, current indications, surgical technique, outcomes, and potential side effects.