If PSA is elevated after prostate cancer surgery, we should improve the examination to clarify the etiology, and choose regular testing, endocrine therapy, radiotherapy and chemotherapy according to the degree and cause of elevation. Serum PSA is the current biological index of prostate cancer, which can be used for screening, early diagnosis, staging, efficacy evaluation and follow-up observation of prostate cancer, etc. It is widely used in clinic. PSA should not be detected 6 weeks after successful radical prostatectomy, but PSA is still elevated, indicating that there are PSA-producing tissues in the body, i.e. residual lesions. Because there is a clearance period for PSA, the first PSA test after radical prostatectomy should be performed between 6 weeks and 3 months after surgery, and should be repeated when an elevated PSA level is detected to rule out testing errors, and no clinical or biochemical progression can be considered to have occurred at a level of less than 0.2 ng/ml. Currently, two consecutive PSA levels above 0.2ng/ml are considered to indicate biochemical recurrence, and a rapid rise in PSA suggests the possibility of distant metastasis, while a slower rise in PSA may be indicative of local recurrence. Therefore, when PSA is elevated after surgery, the cause of the elevation should be examined as soon as possible, whether it is residual lesions, laboratory error, residual PSA not cleared, or the emergence of new foci/metastases, etc. Depending on the degree and cause of the elevation, regular testing, endocrine therapy, radiotherapy, chemotherapy, and immunotherapy, etc. should be chosen, and please consult with a specialist for the specific plan. It is recommended to go to a regular hospital for a comprehensive assessment of the condition and follow the doctor’s instructions to avoid delaying the condition.