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Experimental and epidemiological evidence suggests that cholesterol may play a promotional role in prostate cancer development and progression. This review seeks to provide an overview of established links between cholesterol and prostate cancer, with an emphasis on very recent scientific contributions supporting a role of cholesterol in prostate cancer etiology.Elevated cholesterol levels in prostate cancer cells have been found to result from aberrant regulation of cholesterol metabolism. Recent studies have identified Akt/protein kinase B and sterol response element binding proteins as major players regulating cholesterol biosynthesis and feedback regulation. It has also become apparent that prostate cancer cells process critical cell survival cues via specialized membrane microdomains that are dependent on cholesterol for signal transduction. These findings converge to support a scenario in which abnormal cholesterol metabolism influences signal transduction events at the membrane in a manner that promotes tumor cell growth, inhibits apoptotic signals and potentially stimulates other malignant cellular behaviors.Recent experimental evidence has invigorated the discussion of a role for cholesterol in prostate cancer. The identification of cholesterol as a critical component in signal transduction events in prostate cancer cells has not only provided new mechanistic insights but also opened up new avenues for chemotherapeutic intervention.