Genomics is the science of how genes influence human health and disease states. It differs from traditional genetic screening in that the transcriptional activity (or other markers) in full panels of related genes are studied. Compared to simple genetic testing, assessment of expression levels in a panel of genes provides a more nuanced and holistic understanding of genetic modulation of human disease. Genomic testing may be used to great effect in resolving controversial questions on detection and treatment of prostate cancer. Genomic tests are currently in use for numerous facets of prostate cancer care, including screening, biopsy, and treatment planning. The clinical validity (predictive capacity) of these assays has been well established; studies on clinical utility (i.e. usefulness of these tests in guiding patient/provider decisions) have shown promising results. Men’s health specialists should be familiar with the role genomic testing will play in contemporary management of prostate cancer.