Sarcoma of prostate includes rhabdomyosarcoma, smooth muscle sarcoma, fibrosarcoma, spindle cell sarcoma, liposarcoma, neurogenic sarcoma, lymphosarcoma, mucinous sarcoma, hemangiosarcoma, chondrosarcoma, etc., of which rhabdomyosarcoma is the most common. Its pathogenesis includes a variety of factors: environmental, immune, genetic, of which several reports have now confirmed that radiotherapy may be a causative factor in causing prostate sarcoma. Prostate sarcoma is rare, and was first reported by Stafford in 1829. Cao Chentao first reported a case in 1930. In the United States, sarcoma accounted for only 0.09% of the deaths from malignant tumors of the prostate. Prostate sarcoma accounted for 0.1%~0.3% of prostate malignant tumors in western developed countries, and 2.7%~7.5% in China. This significant difference may be related to the high incidence of prostate cancer in western countries and the low incidence of prostate cancer in China. Prostate sarcoma occurs earlier than prostate cancer and has a poor prognosis. Symptoms do not appear in the early stages, and the tumor is quite large when symptoms appear. Generally, early symptoms are bladder neck obstruction, tumor compression of bladder base or invasion of urethra can affect urination, manifested as urinary frequency, urinary pain and difficulty in urination, hematuria is rare. In severe cases, compression of rectum may cause defecation difficulty. In the late stage, the symptoms are pain, obvious emaciation, anemia and malignant quality, and easy to metastasize to lung, liver and bone. Prostate sarcoma originates from the germinal bundle mesodermal tissue, with a variety of pathologic structures and morphologies, and a broadly similar biological behavior; it is an extremely malignant tumor. The diagnosis of sarcoma relies on the gold standard of morphopathology, in addition to several other techniques that may help in the diagnosis and clarify the classification: immunohistochemistry, cytogenetics, electron microscopy, and molecular genetic testing. Lowsley classified the pathology of prostate sarcomas into 3 categories: 1. myosarcoma: rhabdomyosarcoma, leiomyosarcoma; 2. fusocellular sarcoma: including fibrosarcoma. 2, fusocellular sarcoma: including fibrosarcoma and fusocellular sarcoma; 3, other sarcomas: mucinous sarcoma, liposarcoma, osteosarcoma, neurogenic sarcoma and so on. Clinical manifestations of early no typical symptoms, late due to tumor enlargement and compression leading to urinary difficulties, especially combined with obvious constipation, anal finger touch painless prostate mass, with cystic fluctuation sensation, bladder capacity shrinkage, cystoscopy to see the neck of the external pressure of the mass, imaging to see the bladder neck huge filling defect and urethral shift deformation, pelvic ultrasound and CT have diagnostic value, puncture biopsy can be obtained to determine the diagnosis of the pathology. For the treatment of this disease, currently the best surgical treatment for early lesions: radical prostatectomy is preferred for patients confined to the prostate envelope without local infiltration. Accompanied by local invasion of the bladder, urethra or rectum without distant metastases, conditions allow feasible pelvic contouring. For those with metastasis or localized infiltration, palliative surgery is feasible to relieve symptoms, including transurethral resection of the prostate. Radiation therapy: It is an important adjuvant treatment measure, which can be applied preoperatively or postoperatively. Smooth muscle sarcoma is moderately sensitive, whereas rhabdomyosarcoma should not be treated with radiotherapy. Interventional chemotherapy and lymphatic chemotherapy: It can increase the dose of chemotherapeutic drugs in the tumor tissue to enhance the therapeutic effect and at the same time reduce the toxic side effects. Actinomycin D, vincristine, cyclophosphamide, etc. have certain efficacy and have synergistic effect when combined with radiotherapy. Prostate sarcoma develops very quickly and has a poor prognosis, with few surviving more than 1 year after diagnosis. Almost all rhabdomyosarcomas die within 1 year, with an average survival of 6.5 months after the onset of symptoms. Smooth muscle sarcoma has a slightly better prognosis, with an average survival of 2 to 3 years for those over 20 years of age and 2.5 years for those under 20 years of age.