Objective: This study was to clarify the effects of H19 genetic variant rs2839698, rs217727, rs3741216 and rs3741219 on renal cell carcinoma (RCC) susceptibility and prognosis. Methods: We conducted this two-stage case-control study with a total of 1014 RCC cases and 1063 controls since May 2004. 355 RCC cases in the first stage had complete follow-up data available. Genotyping was performed using TaqMan real-time polymerase chain reaction assays. Odds ratios (ORs) and 95% confidence interval (CI) were calculated to evaluate the association between H19 polymorphism and RCC risk and clinical characteristics. Kaplan-Meier method was utilized to assess the survival of H19 polymorphisms. Hazard ratios (HRs) and 95%CI were calculated by COX regression model to discover whether genotypes, TNM and grade were the independent prognostic factors. Results: Compared with the H19 rs2839698 CC genotype, the variant genotypes (CT/TT) were significantly associated with increased risk of RCC (P=0.012, OR=1.13; 95% CI=1.02-1.55). Besides, patients with variant genotypes (CT/TT) were more likely to develop large tumor (P=0.003, OR=1.35; 95% CI=1.10-1.73) and advanced T stage (P=0.010, OR=1.63; 95% CI=1.08-2.21); and had a significantly unfavorable 5-year survival than those with the rs2839698 CC genotype (CT/TT vs CC: Log-rank P=0.027, HR=2.24, 95%CI=1.10-4.59). Conclusion: Our results suggested that the H19 rs2839698 variant may be a genetic predictor of susceptibility and mortality of RCC. The precise functional impact of the variant on H19 still needs further experimental validation.