Prostate cancer (PCa) is one of the most common malignancies in men. Its clinical behavior ranges from indolent to aggressive. The clinical and morphological methods and features currently adopted show a low predictive value concerning the definition of its level of aggressiveness. Investigations have been led to understand its complex genomic landscape to improve diagnosis and prognosis as well as to define the potential role of new therapeutic targets. Epigenetic changes, including modifications in DNA methylation and histone acetylation, can contribute to the clinical behavior of PCa. MicroRNAs (miRNAs) can be used as potential biomarkers in the definition of PCa. The reversibility of epigenetic modifications opens the door to a potential perspective in the development of epigenetics modulators. The scope of this contribution is to review the main epigenetic modifications identified in PCa, including research on epigenetic modifiers and modulators.