Castration-resistant prostate cancer (CRPC) is progressive prostate cancer in background androgen suppression. Molecular testing for HRR (Homologous Recombination Repair) alteration and MSI (Micro-satellite Instability) status is essential in the evaluation of CRPC. The treatment of metastatic CRPC with HRR alteration incorporates PARP (Poly (ADP-ribose) polymerase) inhibitors with or without androgen receptor pathway inhibitors. Taxanes form backbone of treatment of metastatic CRPC in patients irrespective of HRR alteration. PSMA radioligand therapy is an effective treatment option for refractory CRPC with PSMA expression. Metastatic CRPC with MSI-high status responds to immune-checkpoint inhibition. Second-generation anti-androgens improve survival in non-metastatic CRPC with short PSA doubling time. Metastatic CRPC is an aggressive disease and prognosis is guided by disease volume, visceral metastases, performance status, and prior treatment.