With the established effectiveness of diverse treatments for localized prostate cancer, the identification of the physical and psychological consequences of the disease and its various treatments has become critical. In the present review, we aim to familiarize the reader with the methodologies of health-related quality of life (HRQOL) research and to review the recent literature on HRQOL outcomes in patients with localized prostate cancer. Studies have shown that prostate cancer and its treatment affect both disease-specific HRQOL (i.e. urinary, sexual, and bowel function) as well as general HRQOL (i.e. energy/vitality and performance in physical and social roles). However, these effects appear to differ according to the type of treatment, stage of disease, age of the subjects, time after treatment, and, more importantly, race or ethnicity. By including HRQOL in clinical decision-making, we can help our patients make more informed treatment choices for localized prostate cancer.