Molecular profiling studies of human prostate cancer provide great opportunities to identify new prostate cancer biomarkers to improve prostate cancer detection and treatment. Proteomics has distinct advantages over genomic and ribonucleic acid expression studies because it is the proteins that are ultimately responsible for the malignant phenotype. The goal of traditional proteomic studies is to identify disease-specific biomarkers. Two-dimensional (2-D) gel electrophoresis (polyacrylamide gel electrophoresis; PAGE) coupled with mass spectrometry is the most widely used experimental strategy and, to date, has yielded several potentially relevant prostate cancer biomarkers. A promising prostate cancer biomarker identified by 2-D PAGE and mass spectrometry is annexin I. Studies have already confirmed that annexin I is underexpressed in a majority of early stage prostate cancers. Other non-gel-based proteomic technologies that may have improved sensitivity as compared to 2-D PAGE have recently been developed. An example of this is the ProteomeLab PF 2-D (Beckman Coulter, Inc., Fullerton, CA). The goal of most proteomic studies is to identify biomarkers that can be measured by enzyme-linked immunosorbent assay or immunohistochemistry. Improvements in proteomic technology may be changing this paradigm because there are now efforts to develop proteomic technologies directly into clinical diagnostic tests. An example of this technology is surface-enhanced laser desorption ionization time-of-flight mass spectrometry. Using this technology combined with a pattern recognition based bioinformatics tool, discriminatory spectrum proteomic profiles were generated that could help discriminate men with prostate cancer from those with benign prostates. If several technologic hurdles can be overcome, it is possible that methodology will improve the specificity and sensitivity of prostate cancer detection.