Advanced screening programmes have led to an increased incidence of prostate cancer worldwide. Prostate Cancer is currently the most common site of male cancers worldwide; accounting for 21% of all male cancers in Ireland. This article presents an in-depth review of the available evidence (January 1997 to April 2007), which directly compares outcomes (in terms of urinary function, bowel function, sexual function, quality-of-life (QOL) outcomes and survival statistics) post radical prostatectomy versus a conservative watch-and-wait approach for the treatment of clinically localized prostate cancer. The aim of this paper is to equip health-care professionals with the best available research evidence. Best research evidence is a component of evidence-based practice, which is very much 'in vogue' in health care today. The authors recommend that practitioners utilize this, the available evidence in combination with their clinical expertise and their patients' opinions in order to assist these patients' to make wise and informed treatment decisions. As this paper will demonstrate, the treatment chosen can have important implications in terms of patient outcomes. Therefore, making an informed decision early on can prevent any regret at a later stage. Overall this review of the literature revealed significant disparity in terms of which treatment option is more favourable. Patients overall are faced with a difficult dilemma when making this treatment decision - to live longer at the expense of potential erectile dysfunction and possible urinary incontinence or to live for a potentially shorter time without these adverse consequences..