Neoadjuvant androgen deprivation therapy has consistently demonstrated a 50% decrease in the positive margin rate in patients with clinical stage T2 prostate cancer undergoing radical prostatectomy compared with patients without prior therapy. Clinical correlates in terms of changes in progression rate or survival are not yet available. Early analyses of ongoing trials show no difference between the treated or control groups in the commonly used surrogate of progression, the rate of detectable prostate-specific antigen. The adoption of neoadjuvant therapy should await more definitive results of these trials.