Oligometastatic prostate cancer can be defined as a narrow number of metastases in the lymph nodes and/or bones, with no visceral organ metastases. It requires precise imaging techniques covering a wide range of diseases. Cytoreductive radical prostatectomy is a method that can be safely applied and well tolerated in a well-selected group of patients and can prevent complications due to the progression of local disease. Preliminary results suggest that radical prostatectomy may improve oncological survival in the context of a multimodal treatment approach, while waiting for the results of prospective randomized controlled studies to clarify treatment options.