INTRODUCTION It is worth distinguishing between the two strategies of expectant management for PCa. WW entails administering non-curative androgen deprivation therapy to patients upon development of symptomatic progression, whereas AS entails delivering curative treatment upon signs of disease progression. The objectives of the two management strategies and the patients enrolled in either are different. AIM To review the role of AS as a management strategy for patients with low-risk PCa and review the benefits and pitfalls of AS. METHODS We performed a systematic review of AS for PCa in the literature using the National Center for Biotechnology Information's electronic database PubMed. We conducted a search in English using the terms: active surveillance, prostate cancer, watchful waiting, and conservative management. Selected studies were required to have a comprehensive description of the demographic and disease characteristics of the patients at the time of diagnosis, inclusion criteria for surveillance, and a protocol for the patients’ follow-up. Review articles were included but not multiple papers from the same datasets. CONCLUSIONS AS appears to reduce overtreatment in patients with low-risk PCa without compromising cancer-specific survival at 10 years. Therefore AS is an option for select patients who want to avoid the side effects inherent to the different types of immediate treatment. However, inclusion criteria for AS and the most appropriate method of monitoring patients on AS have not yet been standardized.

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