Cabozantinib is a commonly prescribed tyrosine kinase inhibitor for metastatic renal cell carcinoma (mRCC). Dose reductions may be required to manage side effects. Data was collected at University Hospitals Plymouth NHS Trust between 2020 and 2024 to investigate the dosing of Cabozantinib and its impact on cancer control. Starting at a reduced dose was common, with only 17% starting at full dose (60 mg). Only 9% completed their Cabozantinib course at 60 mg, with the majority (61%) ending up taking 20 mg. Dose reductions occurred early, with the vast majority ending up on their final dose at cycle two or three. Median progression-free survival was 7–10 months regardless of dose, and there was no statistically significant difference in PFS or OS according to dose.