Chemotherapy for prostate cancer currently has an established role in the treatment of hormone-refractory prostate cancer. There is strong evidence that combined modality treatment with androgen ablation in addition to radiotherapy provides a benefit above and beyond radiotherapy alone in patients with a poor prognosis, perhaps because of an effect of androgen ablation on subclinical distant disease. There are currently several clinical trials investigating whether the addition of chemotherapy with known efficacy in the hormone-refractory setting can provide a survival advantage when used adjuvantly. The role of chemotherapy for patients with nonmetastatic, hormone-naive prostate cancer will be discussed.