Abstract: Most prostate cancer (PCa) patients in China are diagnosed at an advanced stage. Many PCa patients are initially sensi-tive to hormonal therapy and experience temporary tumor regression, but nearly all of the patients will finally reach a state of castration-resistant prostate cancer (CRPC). CRPC is difficult to cure and thus has poor prognosis. Identification of new therapies to treat CRPC remains an urgent need. Precision medicine individualizes CRPC treatments by tailoring them to the genomic characteristics of CRPC. In this review, we summarize the recent progress of pathogenesis, molecular targeted therapy, and clinical trials of CRPC as well as dis -cuss precision medicine for CRPC.