Abstract: To summarize the diagnosis and treatment of 63 cases of advanced stage prostate cancer with osseous metastasis. Methods: Palliative prostatectomy or endocrine therapy was performed for the 63 cases with osseous metastasis of prostate cancer, among which 1 received radical prostatectomy after neoadjuvant therapy. Results: Fifty- two cases were followed up for 6 to 72 months (averaging 30 months). During that time, 15 patients died of metastasis of the prostate cancer within 12 to 48 months (averaging 21 months) after treatment and 1 patient died of cerebrovascular accident 6 months after treatment. The other 36 surviving cases received follow up for a minimum of 12 months (averaging 34 months), and all survived asymptomatically. The PSA response rate reached 100% 6 months after treatment. Conclusions: The early curative effect of endocrine therapy for cases with osseous metastasis of prostate cancer is obvious, and palliative prostatectomy can improve the quality of life for the patients with symptoms of obstruction.