Pathologic stage strongly influences therapeutic outcome and decision making for men with clinically localized prostate cancer. Prediction of stage has become an essential component in the evaluation of individual patients. Radical prostatectomy is increasingly recognized by practicing urologists as a definitive method for eliminating organ-confined prostate cancer; however, the risk of understaging by clinical examination is significant and associated with a greater likelihood of cancer recurrence. The prognostic importance of pathologic stage would justify the use of accurate predictive models within decision algorithms. This article discusses how information derived from careful clinical and pathologic assessment relates to pathologic stage and may be used for its prediction.