During the 2024 BMUC meeting, an entire session was dedicated to the management of patients with recurrent prostate cancer. In this session, Dr. Alastair Lamb (University of Oxford, UK) highlighted the concept and assessment of biochemical relapse (BCR) post-prostatectomy, stressing the importance of risk stratification. Subsequently, Prof. Bertrand Tombal (Cliniques Universitaires Saint Luc, Belgium) discussed strategies to optimise the systemic therapy for patients at both low and high risk after which Prof. Piet Ost (Ghent University, Belgium) discussed the integration of metastasis-directed therapy with systemic approaches in patients with metachronous metastatic hormone-sensitive prostate cancer.