Abstract: Prostate specific membrane antigen (PSMA)-targeted molecular imaging technology has been widely used in the comprehensive diagnostic and therapeutic management of prostate cancer (PCa) across all stages of the disease. This special issue highlights its core clinical application values: achieving accurate staging by distinguishing primary tumors from metastatic lesions with high sensitivity; significantly improving the detection rate of biochemical recurrence lesions in PCa through precise localization of occult lesions; and facilitating a closed-loop system for PCa diagnosis and therapy based on PSMA expression levels, which supports patient selection for radioligand therapy and enables dynamic monitoring of therapeutic response. By integrating multimodal image fusion, quantitative parameter analysis, and targeted molecular imaging, PSMA-targeted molecular imaging technology provides important support for individualized treatment decisions in PCa.