Recent advances in sequencing technologies, proteomics, and metabolomics have led to the identification of numerous molecular alterations across solid tumors including prostate cancer. The delineation of various genetic and epigenetic events involved in tumor progression have facilitated the development of novel diagnostic tests and the successful therapeutic targeting of key oncogenic events in prostate cancer. The most common genomic aberrations in prostate cancer include gene fusions, amplification, deletion, and mutations. In addition, up and down regulation of gene expression in critical cellular pathways is also at play. A series of long noncoding RNA expression changes have been also unveiled from transcriptome sequencing data. They play a regulatory role in prostate cancer and are promising diagnostic and potentially prognostic markers. In this review, we summarize recent advances in molecular pathology of prostate cancer and their emerging clinical utility. Recent advances in molecular pathology of prostate cancer and their emerging clinical utility are discussed.