Abstract Purpose The impact of radical prostatectomy and external beam radiotherapy on the quality of life of patients was compared. Materials and Methods A total of 136 patients underwent radical prostatectomy and 60 underwent external beam radiotherapy for clinically localized prostate cancer. Patients were asked to complete a questionnaire containing The Functional Living Index: Cancer, the Profile of Moods States, and a series of questions evaluating bladder, bowel and sexual function. Results The radical prostatectomy group had worse sexual function and urinary incontinence, while the external beam radiotherapy group had worse bowel function. Of the patients 90 percent from both groups stated that they would undergo the treatment again. Conclusions Radical prostatectomy and external beam radiotherapy have comparable impact upon quality of life.