This article is a review of the literature concerning the management of lymph nodes (LNs) in early prostate cancer. The literature review was performed using the PUBMED database. The treatment of LNS in early prostate cancer usually requires a pelvic LN dissection (PLND), which is performed in all patients with localized prostate cancer. Sometimes nomograms are used to select patients requiring lymphadenectomy. No consensus is available concerning the indications for the performance of PLND and the extent of the lymphadenectomy that should be performed. Recent non-surgical methods detecting LN invasion seem promising, but further investigations and a consensus attainment for terminology and investigation methodologies are advisable.