To date, prostate cancer remains the most common tumor diagnosed in males and the second most common cause of cancer-related mortality. While current screening protocols can detect early disease, they lack enough sensitivity and specificity, leading to unnecessary biopsies and overtreatment. Furthermore, disease monitoring remains challenging, as current prognostic strategies rely on data obtained by invasive means such as biopsy, surgery and digital rectal examination. Additionally, there are no tools to predict tumor progression, risk reclassification and treatment response. As the need for accurate biomarkers continues, miRNAs are promising biomarkers for screening, surveillance, prognosis and treatment response in prostate cancer. In this review, the authors describe the current evidence regarding the accuracy and efficacy of these biomarkers for prostate cancer.