This report is an update to a Comparative Effectiveness Review on management strategies for renal artery stenosis (RAS) from October 2006. The systematic review included all studies of patients with atherosclerotic RAS (ARAS) that compared two or more interventions. It also reviewed recent prospective cohort (single arm) studies of angioplasty with stent placement, prospective cohort studies of medical interventions, cohort studies of RAS natural history, and prospective or large retrospective studies of surgical bypass. This update evaluated the same questions and used the same eligibility criteria, updating the literature search through April 23, 2007. This report does not address the management of fibromuscular dysplasia, renal transplant recipients, or patients who have a previous failed revascularization.