Abstract: Prostate specific membrane antigen (PSMA) targeted radioligand therapy (RLT) is being increasingly implemented in China, providing an important strategy for the precision treatment of advanced prostate cancer. Based on the latest global evidence and the Delphi method, this consensus formulates 14 recommendations covering key aspects of PSMA RLT, including patient selection, imaging evaluation, risk stratification, and treatment contraindications for metastatic castration-resistant prostate cancer. It aims to standardize the clinical application of PSMA RLT in China, optimize patient stratification and management, promote the implementation of precision medicine, and ultimately improve patient quality of life and treatment outcomes.