Shared decision making (SDM) is a collaborative approach in medical care that improves the quality of medical decisions by helping patients choose options concordant with personal values and in accordance with best practice of scientific evidence. The increasing focus on patient-centered care has made SDM adopted more and more common in in recent years. With the progress in prostate cancer therapies, patients with metastatic prostate cancer presented the benefits and harms of different health care choices. In this review, we will discuss the application of SDM in metastatic prostate cancer and how is SDM capable of coming to shared decision making in clinical practice. The review will also discuss the limitations and prospective development of SDM in the urological field.