When non-cutaneous tumor excluded, prostate cancer is the most common malignancy of men in the Western communities, and it is the second cause of cancer related deaths. Prostate cancer is a slowly progressive kind of malignancy. Although the incidence of histologically documented prostate cancer is approximately 30-40% in men over 50 years, the incidence of prostate cancer related deaths is only 3%. In the majority of patients, prostate cancer never threatens life. Recently there has been a significant increase in the number of low-risk prostate cancers because of the improvements in biopsy techniques as well as the performance of widely used PSA in screening. In most of these patients, cancer is clinically insignificant. However, quality of life is generally threatened in these patients because of the complications associated with unnecessary over treatment. Active surveillance has become a management option in low-risk prostate cancer patients keeping the curative treatment option in hand. Since studies associated with active surveillance consist of variabilities in patient selection criteria as well as the criteria used for the markers of clinical and histological progression and the decision-making process about radical treatment, more evidence and further studies are needed in order to define universal criteria for such purposes.