PURPOSE: To evaluate the results of two-injection ethanol sclerotherapy in simple renal cysts performed with 5-minute ethanol exposure time. MATERIALS AND METHODS: We retrospectively reviewed 30 renal cysts in 30 patients treated by ethanol sclerotherapy between November 2002 and October 2015. Under ultrasound guidance, the renal cyst was punctured and a 7 Fr pigtail catheter was inserted, and then complete aspiration of the cystic fluid was performed. Then, 99.9% ethanol in a quantity amounting to 1/3–1/2 of the aspirated volume was infused into the cyst and it was immediately removed. The same amount of ethanol was re-infused and removed after 5 minutes. Follow-up examination was performed using ultrasound or CT images at least 3 months after the procedure and pre- and post-treatment cyst volumes were estimated. The therapeutic response was classified as either complete success (volume reduction, ≥ 95%), partial success (volume reduction, 50–95%), or failure (volume reduction, < 50%) based on the volume reduction rate. RESULTS: The average volume reduction rate was 96.3%. The rates of complete success, partial success and failure were 80% (n = 24), 20% (n = 6), and 0% (n = 0), respectively. There was no complication except for minor flank pain. CONCLUSION: Two-injection ethanol sclerotherapy with 5-minute exposure time represents a simple and effective treatment for simple renal cysts.