Background: The complex and rapidly evolving treatment (Tx) landscape for advanced RCC poses challenges for healthcare providers (HCPs), particularly those in community settings, to make Tx decisions. To better understand current RCC Tx patterns, we analyzed patient (pt) cases entered by HCPs in an online tool developed by 5 experienced RCC experts from leading academic institutions. Methods: The tool, developed in 2016 and updated in 2017, includes over 500 case variations based on key factors defined by the experts. HCPs enter pt information and their intended Tx plan; the tool provides expert Tx recommendations for the pt case entered, followed by a survey to determine if the recommendations changed the HCP Tx plan. This analysis compares intended Tx of HCPs vs expert recommendations for 1027 cases entered into the tool (2016, n = 470; 2017, n = 557). Pearson chi-squared and Fischer’s Exact tests were used for analyses. Results: There was substantial Tx variation between HCPs and experts. In the first-line setting, 65% of HCPs vs 81% of experts selected sunitinib or pazopanib in both 2016 and 2017 (P = .0014). After disease progression (PD) on a first-line TKI, experts selected nivolumab (nivo) as second-line Tx more often than HCPs (98% vs 26% in 2016, P < .0001; 89% vs 37% in 2017, P < .0001). There were significant changes in practice patterns from 2016 to 2017 for both experts and HCPs in pts who received 2 prior lines of Tx. After PD on a first-line TKI and then nivo, experts recommended cabozantinib as the TKI of choice in 76% of cases in 2017 vs 40% in 2016. After PD on a first-line TKI and then either axitinib or everolimus, experts selected nivo more often than HCPs (84% vs 30%, respectively; P = .002) in 2016; however, expert and HCP Tx plans were not significantly different in 2017 (100% vs 70%, respectively; P = .08). Of the survey respondents, 46% of HCPs who differed from experts in their Tx selection indicated that the tool changed their intended Tx. Conclusions: Practice patterns between experts and HCPs differed substantially in pts with Tx-refractory RCC. Given that expert recommendations often changed the Tx plan of HCPs, the potential of an online tool to improve clinical outcomes in pts with advanced RCC warrants further investigation.