Recently, the diagnosis of prostate cancer is performed in an early stage and in younger patients. Moreover, the development of new technologies for improving seed implant has increased the interest in brachytherapy for prostate cancer. New technologies have significantly improved treatment accuracy, efficiency, and outcomes in brachytherapy. Here, we will discuss the recent acquisitions in terms of technologies, instrumentations, and procedures in brachytherapy. Moreover, the oncological, functional, and quality of life-related results will be discussed, with attention to the lack of randomized clinical trials. However, based on the analysis of all reported experiences, the European Association of Urology (EAU) suggested that the use of brachytherapy should be limited to patients with a low risk or National Comprehensive Cancer Network® (NCCN®)–favourable intermediate risk and good urinary function (prostatic symptom score <12 and maximum flow rate >15 mL/min). EAU guidelines give specific recommendations for the use of high-dose-rate brachytherapy or low-dose-rate brachytherapy in combination with external beam radiation therapy.