It is thought that over forty percent of an individual's risk of developing prostate cancer (PCa) is related to familial and genetic factors. Although multiple genes have been implicated in the development of PCa, few confer as high a risk as mutations in the genes associated with early-onset breast cancer (BRCA1 and BRCA2). Not only do mutations in BRCA genes increase the risk of PCa, but they have also been related to adverse disease characteristics and outcomes. Therefore, a better understanding of the association between BRCA gene mutations and PCa may provide the backdrop for individualized management of patients with PCa who are carriers of a gene mutation. Such management may include an individualized approach to screening and treatment including chemotherapeutic regimens targeted to the underlying genetic mechanism of disease. In this paper, we review the evidence relating BRCA gene mutations to the risk of PCa, as well as outcomes and response to therapy, and suggest an approach to the management of such patients.