Over 200000 cases of prostate cancer will be diagnosed in the United States in 2007. Management of this common malignancy is controversial with essentially equal long-term survival and local control with either surgery or radiation therapy stage for stage in the setting of localized disease. Factors that can affect treatment recommendations include stage and grade of disease, the pre-treatment PSA, physician bias and patient choice. This paper examines several of the radiotherapeutic options for the treatment of prostate cancer, and will also discuss evolving modalities that may offer additional treatment choices in the future.