Renal cysts are a common clinical finding necessitating a nuanced approach to management. This study explores outcomes and patient characteristics associated with two interventions for renal cysts: Aspiration of renal cyst povidone-iodine sclerotherapy and laparoscopic renal cyst deroofing. A study was conducted on patients admitted to urology and nephrology hospitals at Assiut University between February 2022 and December 2022. The study population included adult patients diagnosed with renal cysts. Data included demographic information, operative times, postoperative complications, and follow-up assessments. Our findings revealed the effectiveness of single-session povidone iodine sclerotherapy with a high success rate of 95% and the patients who underwent laparoscopic deroofing had significantly longer operative times compared to those who underwent aspiration (p < 0.001). Gender did not significantly influence operative time (p = 0.583), but age exhibited a marginal association (p = 0.0667). Notably, the presence of complications, particularly serosal abrasion (p = 0.001), was strongly linked to increased operative times. Hematoma, bleeding, and pain showed no significant impact on operative time. Re-do procedures were infrequent in both groups. This study showed the outcomes of two common interventions for renal cyst management. The effectiveness of a single session of povidone-iodine sclerotherapy in the management of symptomatic simple renal cysts in comparison to the gold standard technique of laparoscopic deroofing which is associated with longer operative times and more invasiveness. These insights can guide clinicians in selecting appropriate interventions and managing patient expectations.