Radical prostatectomy, external radiation therapy, and brachytherapy are all mainstay treatment options for clinically localized prostate cancer. Over time, each of these treatments has been modified so as to maximize percent cancer-free survival while minimizing health-related risks such as urinary incontinence, bowel incontinence, and sexual dysfunction. With these efforts, there is still not one superior single treatment that is devoid of side effects. Concurrently, efforts have been made to generate validated health-related quality of life (HRQOL) measurement scales to aid in the decision making by both physician and patient. HRQOL measurement scales enable physicians to have informed discussions with patients about potential likelihood of a given set of side effects with the various prostate cancer treatment options. This review will highlight prostate cancer HRQOL outcomes and delineate further areas of study necessary to optimize evidence-based decision making for prostate cancer patients.