OBJECTIVE: This study seeks to synthesize and identify gaps in the economic literature of prostate cancer (PCA). METHODS: English-language abstracts and articles published between 1990 and mid-2005 were retrieved from MEDLINE, conference proceedings, and governmental databases using search terms “prostate cancer”, “prostatic neoplasm”, or similar, combined with a comprehensive list of cost-related search terms. Articles that provided economic data at an individual or societal level were retrieved in full text and analyzed by study type, design, endpoints, results, and other characteristics. RESULTS: Of 1169 abstracts retrieved, 186 met the inclusion criteria, of which most (133 articles, 71.5%) were published since 1999. More than half of the economic evaluations were retrospective, based on chart reviews and database analyses (101, 54.3%). Others were prospective evaluations based on clinical trials or observational studies (73, 39.2%), and economic modeling of PCA screening strategies (12, 6.5%). Cost-of-illness studies were completed in eight developed countries. Assessments of cost per treatment and/or per cancer stage (16, 8.6%) and cost per patient (11, 5.9%) were conducted primarily in the U.S., as were cost studies of mass screening (25, 13.4%) and diagnostic modalities (15, 8.1%). Cost evaluations of curative treatments (43, 23.1%) focused primarily on androgen suppression therapy (13, 7.0%), as well as radical prostatectomy (10, 5.4%), radiation therapy (10, 5.4%), or combination therapies (10, 5.4%). Cost assessments of palliative care (21, 11.3%) focused on hormonal therapy (16, 8.6%). Studies of indirect costs, costs of pharmaceutical preventions (e.g. finasteride) and the economic impact of recurrence after treatment failure were scarce or unavailable. CONCLUSIONS: As the population ages and as earlier detection become more common, PCA is becoming a more important focus of economic assessment. Cost comparisons among treatments or diagnostic modalities will remain challenging without standardized assessments of clinical outcomes that make evaluation of treatment effectiveness comparable across regimens.