Prostate cancer is one of the most prevalent form of cancers and one of the major causes of mortality for men worldwide. Non-metastatic prostate cancer can receive radical prostatectomy or radical radiotherapy. Androgen deprivation therapy is the cornerstone of the treatment for patients with metastatic prostate cancer. However, some patients showed the potential to develop into castration-resistant prostate cancer because of the progression of disease. For those men who developed metastatic disease, genomic sequencing is now more routinely applied to help guiding the choice of precise medicine, including the selection of PARP inhibitor, AKT inhibitor orandrogen receptor pathway inhibitor. This review provides an up-to-date summary of precision medicine for the management of metastatic prostate cancer