Prostate cancer is an extremely prevalent problem, especially in our aging population. The prostate-specific antigen test has revolutionized prostate cancer screening. Significant advances have been made in the usage of prostate-specific antigen and its derivatives, biomarkers, diagnostic imaging techniques, biopsy strategy, biopsy needle design and anesthetic agents. Further improvement in prostate cancer detection hinges on the development of an imaging technique that is tumor specific and sensitive to biological aggressiveness.