Increasing evidence links deregulation of the USP22 deubitiquitylase to cancer development and progression in a select group of tumor types, but its specificity and underlying mechanisms of action are not well-defined. Here we show that USP22 is a critical promoter of lethal tumor phenotypes that acts by modulating nuclear receptor and oncogenic signaling. In multiple xenograft models of human cancer, modeling of tumor-associated USP22 deregulation demonstrated that USP22 controls androgen receptor (AR) accumulation and signaling, and that it enhances expression of critical target genes co-regulated by AR and MYC. USP22 not only reprogrammed AR function, but was sufficient to induce the transition to therapeutic resistance. Notably, in vivo depletion experiments revealed that USP22 is critical to maintain phenotypes associated with end-stage disease. This was a significant finding given clinical evidence that USP22 is highly deregulated in tumors which have achieved therapeutic resistance. Taken together, our findings define USP22 as a critical effector of tumor progression whcih drives lethal phenotypes, rationalizing this enzyme as an appealing therapeutic target to treat advanced disease.