This article provides a review of present evidence that suggests that screening achieves a reduction in prostate cancer mortality. Aspects of quality of life and cost effectiveness are reviewed, as well as present test performance. The questions addressed in this article include the following: Is screening in its present form acceptable as a public health instrument? What changes are needed to improve the screening procedure? What are the research priorities in this field, assuming that the present evidence of prostate cancer mortality reduction is eventually confirmed by ongoing randomized controlled trials?