Prostate adenocarcinoma is the most common non-cutaneous malignancy among men in the United States, and the second leading cause of death. However, most prostate adenocarcinoma diagnoses are now diagnosed at early stages and are curable, or if they recur, are associated with such long survival times that the patients usually succumb to competing co-morbidities. This chapter would discuss a brief history of prostate cancer evaluation and its pertinence today, including the Gleason scoring system, advent of PSA testing, and development of the NCCN classification system that is used today. Alternative classification systems, such as the UCSF-CAPRA scoring system, would also be discussed. The latter half of the chapter will discuss the evolution from personalized medicine to precision medicine, including PSMA imaging and prostate cancer genomics, with ongoing trials and future directions. Furthermore, included within this chapter would be a discussion of selecting appropriate men for active surveillance, and appropriate regimens for active surveillance.