Relatively few therapy options exist for patients with prostate cancer that has become resistant to androgen-deprivation therapy and has metastasized to distant sites. Survival for such patients is poor with a median survival of 20 months from the time of initiation of standard docetaxel-based chemotherapy. Promising new treatments are needed, and several are currently being evaluated, including those that target the hormonal axis, such as abiraterone, chemotherapies, such as satraplatin and ixabepilone, combinations of chemotherapy with other agents, such as bevacizumab and calcitriol, as well as a variety of immunotherapeutic approaches. This review will highlight recent and current studies for many of the promising developments for advanced disease, as well as novel early stage approaches.