OBJECTIVE Hand-assisted laparoscopic surgery has recently been introduced in order to help ease the learning process associated with standard laparoscopic surgery. It has various urological applications in the management of malignant and benign disease of the kidney. The purpose of this study is to review the applications and the success rate associated with hand-assisted laparoscopic surgery. METHODS A comprehensive literature review of hand-assisted urological surgery was performed using MEDLINE search. RESULTS Hand-assisted laparoscopic nephrectomy has been performed for benign and malignant disease, donor renal transplant, and nephron sparing surgery with good success. Patients who undergo the hand-assisted procedure seem to have less perioperative morbidity than those who undergo an open procedure. This approach minimized the warm-ischemia time in renal transplantation. CONCLUSIONS Hand-assisted nephrectomy is a useful tool facilitating the learning process in laparoscopy.