Recent advances in molecular technology have been applied to the detection, staging, and prognosis of prostate cancer. The reverse transcriptase-polymerase chain reaction (RT-PCR) is an exquisitely sensitive tool that allows for the detection of minimal quantities of cells. The assay has been studied clinically to distinguish metastatic prostate cancer patients from controls, and to preoperatively stage prostatic carcinoma; it also has been studied as a marker for postoperative recurrences. We review our experience at Columbia University and reports in the literature from other institutions to date. In addition, we provide our most recent data correlating the "enhanced" RT-PCR for PSA assay of peripheral blood specimens with final pathologic stage in 300 radical prostatectomy patients.