It has been suggested that positive family history constitutes a risk factor for the development of prostate cancer. Familial clustering of prostate cancer might suggest that genetic factors are of importance in the etiology of this disease. To elucidate further the relative importance of genetic factors, we studied prostate cancer among an unselected Swedish twin population. Information from the Swedish Twin Registry and the Swedish Cancer Registry was used. In 4,840 male twin pairs 458 prostate cancers were identified between 1959 and 1989. Among these 16 monozygotic and 6 dizygotic twin pairs were concordant for prostate cancer. Proband concordance rates of 0.192 and 0.043, and a correlation of liability of 0.40 and -0.05 were found for monozygotic and dizygotic pairs, respectively. These differences in proband concordance rates and correlations of liability for monozygotic pairs compared to dizygotic pairs are pronounced. The results indicate that genetic factors might be of importance for the development of prostate cancer. The results of this study indicate the need for further investigations of genetic factors in prostate cancer, including large scale epidemiological studies and investigations of molecular genetics of risk families.