Computer treatment planning for cryosurgery is an area of research and development that will greatly assist the practicing physician and will promote improved quality assurance for clinical procedures. Good planning and precision image-guided treatment delivery are complementary in achieving an optimal treatment outcome. State-of-the-art cryosurgery treatment planning systems are at an early stage of development in comparison with radiation treatment planning systems for external beams. Using 30 years of progress in the area of radiation treatment planning as a guide, this article presents a summary of the avenues for research and development in cryosurgery treatment planning that are likely to accelerate the practical application of precision cryosurgery to a broad spectrum of anatomical sites. Emphasis is placed on prostate cryosurgery, imaging techniques, and recommendations for manufacturers of these systems. Optimization of the clinical procedure in the planning stage using mathematical algorithms to define the positioning and operation of cryoprobes is discussed.