Prostate cancer (PCa) is one of the most frequent cancers in males and one of the leading causes of cancer-related deaths globally. Despite advances in diagnosis and treatment, PCa continues to pose substantial hurdles, especially due to its potential to evolve into more aggressive and treatment-resistant types. Long noncoding RNAs (lncRNAs) are transcripts with more than 200 nucleotides that do not encode proteins and have been identified as pivotal regulators in PCa. They influence crucial cellular mechanisms such as cell cycle control, gene expression, and translation, and their dysregulation is linked to tumour growth, progression, and metastasis. Furthermore, lncRNAs modulate androgen receptor (AR) signalling and act as competitive endogenous RNAs (ceRNAs), sequestering microRNAs to alter target gene expression, therefore driving tumour progression. This review uniquely integrates recent advances in understanding the lncRNA-mediated regulatory networks, highlighting their roles in epigenetic, post-transcriptional regulations and key signalling pathways in PCa. It also underscores the emerging clinical applications of lncRNAs as predictive biomarkers and therapeutic targets, with a focus on personalised medicines. Despite the challenges posed by patient heterogeneity and lncRNAs' complex regulatory networks, ongoing research into lncRNAs holds the promise for improving early diagnosis and advancing the development of more effective, personalised therapeutic strategies. Collectively, this review summarises the current knowledge on growing roles of lncRNAs in PCa pathogenesis, clinical relevance and their therapeutic potential and provides potential insights and future directions for translating lncRNA research into effective clinical applications.