A recent Elsevier survey of 200 urologists and oncologists who treat patients with castration-resistant prostate cancer (CRPC) identified a lack of physician confidence in understanding and using current clinical practices regarding the identification, treatment, and management of patients with CRPC. In response to this knowledge gap, a urologic oncology physician roundtable discussion was convened and a companion summary article created to provide a knowledge-based perspective for optimizing the identification, monitoring, and treatment of patients with metastatic CRPC (http://prostatecancer.urologiconcology.org/). Leading urology experts were selected to discuss how CRPC is defined and monitored, and to elaborate (through the presentation of 2 different cases) on considerations of how the currently approved chemotherapeutics, immunotherapy, and oral androgen inhibition agents can be used in the treatment of metastatic CRPC.