Background: Currently, prostate cancer (PCa) remains a hard nut to crack for the medical community. Therefore, the identification and development of novel biomarkers that can accurately diagnose disease and predict prognosis are of paramount importance. The objective of this study was to examine the clinical value of DACT-2 promoter methylation in serum of patients with PCa, to discover a potential diagnostic marker for PCa. Methods: We investigated the methylation status of DACT-2 in the serum of 64 patients with PCa, 22 patients with benign prostatic hyperplasia (BPH), and 47 healthy subjects by methylation-specific PCR (MSP) and real-time methylation-specific PCR (QMSP). Further, we evaluated the relationship between DACT-2 methylation and clinic pathological parameters. Receiver operating characteristic (ROC) curve analysis was applied to assess the sensitivity, specificity, and diagnostic value of DACT-2 methylation and PSA levels. Results: The results of MSP and QMSP showed that the level of methylation of DACT-2 promoter in patients with PCa was significantly higher than that in patients with BPH and healthy subjects. The PCa patients Gleason score and tumor node metastasis (TNM) positively correlated with promoter methylation level of serum DACT-2. The DACT-2 methylation rate was 0.745 with a sensitivity of 81.8%, and a specificity of 75.0%, the sensitivity, and specificity of PSA was 80.1% and 59.4%. ROC curve results displayed that the diagnostic value of DACT-2 is superior to PSA. Conclusions: Our study confirms that the level of methylation of the DACT-2 promoter in patients with PCa is much higher than that in patients with benign prostatic hyperplasia (BPH) and healthy subjects, suggesting that DACT-2 methylation in serum is a potential biomarker of PCa.