OBJECTIVE The increased clinical availability of a wide variety of molecular tests will potentially reshape the care of both men at risk for prostate cancer and men already diagnosed. It is imperative that clinicians be familiar with indications and clinical relevance of these tests. RESULTS The continued clinical validation in new and expanded clinical cohorts and reports of clinical experience with various molecular markers is a rapidly evolving body of literature. Results of large patient series demonstrate that these markers increase the precision of available information used in clinical management decision-making and joint physician-patient discussions regarding treatment options. CONCLUSIONS These tests may make more accurate management decisions possible for those whom have been 'over-diagnosed' with biologically indolent disease which represents an exceptionally small mortality risk. They also may aid in more accurate diagnosis of significant cancer, as well as more precise application of adjuvant therapy.