Objective: To report our experience with biopsy positive T0 prostate cancer (PCa) and perform a literature review to determine the frequency, clinical outcomes, and predictors of pT0 PCa after radical prostatectomy (RP). Materials and Methods:The records of 497 patients who underwent robot-assisted RP at our institution between 2015 and 2020 were retrospectively reviewed.No patients were diagnosed after the transurethral prostate resection or received preoperative hormone therapy.Clinicopathological features including age, prostate-specific antigen (PSA), body mass index, digital rectal examination, biopsy results, clinical T stage, D'Amico risk, prostate weight, prostatectomy pathology, and follow-up data were analyzed.Results: Overall, 3 patients were classified as pT0 on pathologic examination of the RP.The biopsy re-evaluation revealed that 1 patient did not have PCa.Subsequently, the entire RP specimens were re-analyzed, wherein 2 cases were signed out with no identified carcinoma.The incidence of the pT0 PCa was 0.4% in our series.The median age of patients was 64 years.The median PSA was 14.27 ng/mL.Biopsy Gleason score of 2 patients was reported as 3 + 3.All patients had a tumor in only one core and all were in clinical stage T1c.No biochemical recurrence was found in a mean 21-month follow-up.Eleven studies were identified involving 26,228 patients, wherein 122 (0.46%) were reported with pT0 cases.Most patients with stage pT0 have been reported to have a Gleason score of <7, only one positive core biopsy, and a tumor length of <2 mm. Conclusion:Patients with a Gleason score of 6 and tumors in a single core and length of <2 mm in the biopsy should be informed about the risk of stage pT0.