Abstract Our study aimed to develop a nomogram to predict overall survival (OS) at 1, 3, and 5 years for patients with primary renal neuroendocrine tumor (PRNET). The Surveillance, Epidemiology, and End Results database (2000–2021) was utilized to gather cases and extract data. We performed a multivariate analysis using a Cox proportional-hazards model to identify prognostic factors independently affecting OS. Based on these predictors, a nomogram was constructed and validated internally via a bootstrap resampling method. Finally, we included 266 PRNET patients. The multivariate analysis demonstrated that age, Fuhrman grade, surgery, summary stage, N stage, and histology were prognostic factors independently affecting OS (all P