Introduction: Radical prostatectomy is a successful treatment for organ-confined prostate cancer. Longterm progression-free survival can be achieved without additional treatment in cases with pathological T2 disease in the absence of positive surgical margins. However patients with adverse surgical pathologic findings (eg. extracapsular extension, seminal vesicule invasion, positive surgical margins) are at high risk for tumor progression. Postoperative radiation treatment is an invaluable approach for either preventing recurrence or as a salvage treatment. Recent prospective randomized trials have given superior results with the use of adjuvant radiotherapy for high risk patients after prostatectomy. Improved techniques in radiotherapy cause only to mild to moderate morbidity, which does not add significant toxicity to surgery. The role of hormonal therapy with postoperative radiation therapy is another subject which needs further research.