The management of prostate cancer is one of the core tasks for urologists today. Radical prostatectomy represents a valid therapeutic option for the curative treatment of localised prostate cancer. Urologists are on a continuous search for development of technical modifications and refinements, to reduce morbidity and ameliorate clinical and quality of life outcome. This review focuses on the clinical aspects of preoperative patient selection, the current trends of different surgical techniques and the indication of an adequate lymphadenectomy.