Prostate cancer has a substantial heritable component, which is often under-appreciated in the urologic community. Inherited prostate cancer which may account for up to 10% of cases has been associated with genetic mutations which are also linked with other hereditary cancer syndromes. Therefore, family history indicating inherited prostate cancer predisposition may extend beyond prostate cancer to include other cancers such as breast, ovarian and others. Genetic counseling and genetic testing guidelines for prostate cancer are slowly emerging, which emphasizes the need for urologists and other providers involved in the care of prostate cancer patients to consider referring appropriate prostate cancer patients for genetic counseling. Here we will highlight the key elements involved in prostate cancer risk assessment, current knowledge of genetic contribution to prostate cancer, and factors for urologists and other providers to consider when referring prostate cancer patients for genetic counseling.