Renal cell carcinoma was becoming more common, according to national databases (RCC). Over 27 years, the Pennsylvania Cancer Registry was queried to identify further the incidence, geographic distribution, and statewide trends of new RCC cases. Average annual percentage changes (APCs) in age-adjusted rates were modelled using JoinPoint Trend Analysis Software (AAR). Using the R 4.0.2 software, maps of county-level disease incidence rates and stage distribution across the state were constructed in 5-year time intervals. Between 1990 and 2017, 59,628 instances of RCC were reported in Pennsylvania. About 86%  of the patients were over 50, 61% were men, and 89% were Caucasians. Using the SEER staging approach, 64% of the stages were local, 17% regional, and 16% remote. The AAR of all RCC cases increased from 9.9 to 18.0 patients per 100,000 population over the research period, with an APC of 2.3% (p<0.01). With an APC of 3.2%, the AAR of local disease increased from 5.4 to 12.7 individuals per 100,000 population (p<0.01). With an APC of 1.0% (p=0.01), the AAR of regional disease increased from 1.9 to 2.9 individuals per 100,000 people. The rate of rising was higher in younger patients (50 years) than in older patients (APC 3.8% vs 2.0%, p<0.05). A geospatial analysis of new RCC patients revealed particular geographic clusters with higher disease incidence. RCC was more common in Pennsylvania over the last 27 years. At the time of presentation, one-third of the cases were localised or metastatic, and the increasing rates were highest in younger individuals.