Radical prostatectomy is the gold standard surgical treatment for clinically localized prostate cancer. Over the years, many different approaches to surgical removal of the prostate have been described. Today, the most common techniques are open radical retropubic prostatectomy and robotic-assisted laparoscopic radical prostatectomy. Although there are many differences between the 2 approaches, the common goal is to optimize oncologic and functional outcomes. This article highlights the background, techniques, and outcomes of open and robotic prostatectomy.