INTRODUCTION: The purpose of this study was to evaluate the utility of prostate-specific antigen (PSA) screening for prostate cancer after subcapsular prostatectomy. MATERIALS AND METHODS: Data from 41 consecutive patients who underwent subcapsular prostatectomy at a single institution over a 15 year period were collected retrospectively. Patients were categorized into benign and malignant groups based on a diagnosis of prostate cancer identified in the surgical specimen or during subsequent follow up. Collected data included patient age, preoperative and postoperative PSA values, prostate volume determined by surgical specimen weight, and pathologic diagnosis. Preoperative and postoperative PSA velocities were calculated for patients with adequate data and average values were compared to determine factors that were predictive of a confirmed prostate cancer diagnosis. RESULTS: Thirty-one patients had adequate PSA values and follow up and were included in the analysis. Six (19%) were ultimately diagnosed with prostate cancer and 25 (81%) were never diagnosed with prostate cancer. Postoperative PSA velocity was found to be significantly higher for patients in the malignant group (1.22 +/- 1.32 ng/mL/yr) as compared to patients in the benign group (0.06 +/- 0.15 ng/mL/yr) (p = 0.003). CONCLUSIONS: After subcapsular prostatectomy, patients with prostate cancer in the surgical specimen or who developed prostate cancer during long term follow up had elevated PSA velocity compared to patients who had no evidence of cancer in the surgical specimen or in follow up.