Prostate cancer (PCa) is a leading cause of cancer-related deaths among men. Men of African descent have the highest incidence and mortality rates of PCa worldwide. In our environment, most of the patients with PCa present with advanced disease. Androgen deprivation therapy (ADT) remains the cornerstone of primary treatment for men with advanced disease. ADT can be in form of surgical or medical castration (LHRH analogue, Zoladex). The aim of this study is to compare the biochemical efficacy of medical castration (Zoladex®) with bilateral orchidectomy in reducing serum testosterone and serum PSA in patients with advanced PCa at LASUTH, Ikeja. ADT still remains the mainstay of management of advanced PCa. Medical castration ( Zoladex® ) and surgical castration (orchidectomy) are both efficacious in the short term treatment of advanced PCa. Early response to PSA control is found to be slightly better with surgical than medical castration