Overview and treatment guidelines for image-guided treatment in prostate cancer management. Imaging modalities. Modeling potential benefits from IGRT. Pelvic and prostate anatomy, implications for IGRT. Image-guided treatment planning and localization modalities. Image-guidance: the urologist perspective. IGRT in prostate cancer: focus on fiducials. IGRT in prostate cancer: focus on BAT and ultrasound. IGRT in prostate cancer: focus on adaptive therapy. IGRT in postoperative RT for prostate cancer. The use of image-guidance in prostate brachytherapy. IGRT in prostate cancer: targeting pelvic lymph nodes. Fractionation issues with IGRT for clinically localized prostate cancer. Image-guided proton beam radiotherapy. Future developments: On-line dosimetric verification and cone-beam RT planning and verification.