Prostate cancer (PCa) is a malignant tumor with high incidence and mortality rates worldwide. Its insidious early symptoms make early screening and diagnosis crucial. This review systematically elaborates on the common methods and latest research advances in early screening for PCa. Traditional methods such as digital rectal examination (DRE) and prostate-specific antigen (PSA) testing, while widely used clinically, have limitations including high operator dependence and insufficient specificity, potentially leading to missed diagnoses or overdiagnosis. In recent years, significant progress has been made in imaging techniques. Multiparametric magnetic resonance imaging (mpMRI) has become a cornerstone for evaluating suspicious lesions and guiding targeted biopsies. Derived technologies of transrectal ultrasound (TRUS), such as superb microvascular imaging (SMI), contrast-enhanced ultrasound (CEUS), and elastography, have significantly improved diagnostic efficacy through multimodal fusion. Positron emission tomography/computed tomography (PET/CT), particularly prostate-specific membrane antigen (PSMA)-targeted PET/CT, shows great potential in precise staging and detection of metastatic lesions. Meanwhile, emerging biomarkers such as the prostate health index (PHI), 4Kscore, urinary non-coding RNAs (e.g., PCA3), and circulating tumor DNA (ctDNA) from liquid biopsies provide new avenues for non-invasive and precise risk stratification and personalized diagnosis and treatment. Furthermore, risk prediction models based on molecular characteristics and radiomics are advancing PCa management towards personalized medicine.