Management options for localized prostate cancer include radical prostatectomy (RP), radiation therapy (external-beam radiation therapy [EBRT] or brachytherapy), with and without androgen-deprivation therapy (ADT), or active surveillance, also known as watchful waiting. Ultimately, the choice of treatment is determined by a variety of factors, including institutional preference, individual physician judgment, patient preference, and resource availability. In this editorial, we make the case for radiation therapy (EBRT or brachytherapy) as the management modality of choice for localized prostate cancer.