35 of 54 patients undergoing radical prostatectomy for localized cancer were asymptomatic and the tumor had been found during a routine check-up by the family physician. In 53 of 54 patients the indication for surgery was based on a positive cytological finding in fine-needle aspiration biopsy of the suspected tumor. In all patients the carcinoma was confirmed by histological work-up of the radical prostatectomy specimen. Cytological and histological grading was identical in three quarters of all patients. However, the preoperative tumor stage (T) was confirmed histologically (pT) only in half of all the patients. The extension of the carcinoma was often underestimated at the preoperative clinical staging. After a mean observation time of close to 4 years, the survival rate in patients undergoing radical prostatectomy for localized cancer is comparable to an age and sex matched control group. Our data suggest that fine-needle aspiration biopsy of the prostate is a very reliable procedure in the diagnosis of prostatic carcinoma, provided the aspiration technique is correct and the smears are interpreted by a well-trained cytologist. Moreover, patients with localized prostate cancer seem to have an excellent chance of survival with low morbidity, provided the indication for surgery is restricted to carefully selected patients.