Background: Bilateral subcapsular orchiectomy (BSO) is commonly said to be more psychologically rewarding than bilateral total orchiectomy (BTO). However doubts still persist about the effectiveness of BSO in achieving castrate levels of testosterone. This study was conducted on patients with advanced prostate cancer. The aim of this study was to compare post-orchiectomy serum testosterone levels, serum PSA levels and quality of life of patients who had bilateral subcapsular orchiectomy (BSO) performed on them to those of patients who had bilateral total orchiectomy (BTO) over three months. Methods: Sixty-one patients with advanced prostate cancer (histologically diagnosed) opting for bilateral orchiectomy were studied. Thirty-one ultimately had bilateral subcapsular orchiectomy (BSO group) while thirty had bilateral total orchiectomy (BTO group). Blood samples were collected and analyzed for serum testosterone and PSA pre-orchiectomy, one month and three months post-orchiectomy. Quality of life of these patients was also assessed at these same time intervals using the Functional Assessment of Cancer Therapy for prostate cancer (FACT-P) questionnaire. Results: Serum testosterone levels in the BSO group were significantly higher at one month (average of 2.98nmol/L ± 2.24 compared to 0.82nmol/L ± 0.47 in BTO group) and three months (average of 1.98nmol/L ± 2.56 compared to 0.63nmol/L ± 0.20 in the BTO group). At one month and three months respectively, 32.25% and 61.29% of the patients in the BSO group had achieved castrate levels of serum testosterone. There were no significant differences in serum PSA levels, fractional fall in PSA levels and quality of life scores at one month and three months except for the PWB score which was lower in the BSO group. Average scores of responses to item P5 (I am able to feel like a man) generally declined over the months but showed no statistical differences on comparison of the 2 groups of patients. Conclusion: Post orchiectomy serum testosterone levels were significantly higher and more variable in the BSO group. However, Serum PSA levels and overall quality of life did not significantly differ between these two groups at these periods suggesting that the outcomes/results were similar. No statistically significant difference in self-perception as a man or body image was detected post orchiectomy as assessed using item P5 on the FACT-P questionnaire.