Laparoscopic pelvic lymphadenectomy and radical perineal prostatectomy performed under the same anesthetic provide accurate surgical resection of localized carcinoma of the prostate with reduced intraoperative blood loss, minimal postoperative discomfort, short hospital stay (mean 4.1 days), high level of postoperative continence (81% completely dry after 4 months postoperatively) and low morbidity (4 complications). The clinical records of 37 patients undergoing this combined procedure during the last 22 months were reviewed retrospectively and the efficacy of the procedure was evaluated. This combined treatment modality avoids an abdominal incision and pelvic drains, and is associated with minimal postoperative discomfort and a short hospital stay. Laparoscopic pelvic lymphadenectomy combined with radical perineal prostatectomy is an alternative to open pelvic lymph node dissection and radical retropubic prostatectomy.