The efficacy of mTOR inhibitor everolimus for targeted first-line, second-line, and sequential treatments of renal cell carcinoma is investigated and adverse reactions are summarized through introducing the PI3K/AKT/mTOR signaling pathways and their roles in renal cell carcinoma. It has been shown that everolimus alone has poor efficacy in first-line treatment, supporting the strategy mentioned in renal cell carcinoma treatment guidelines that everolimus can be used in second-line treatment after unsuccessful treatment with anti-angiogenic tyrosine kinase inhibitors. First-line treatment with everolimus plus other drugs requires further investigation. Everolimus has generally good tolerance, but the problem of high rate of grade 3-4 adverse reactions still needs to be solved.