We conducted a retrospective review of 345 patients who underwent radical prostatectomy between 1991 and 1994 to assess the overall accuracy, sensitivity, and specificity of computerized tomography (CT) for detection of disease outside the prostate. In 139 patients who were eligible for study, the overall accuracy, sensitivity, and specificity were 51%, 79%, and 30%, respectively. For lymph node metastases only, the values were 89%, 7%, and 97%, respectively. For local extraprostatic extension, the values were 48%, 30%, and 83%, respectively. The overall positive predictive value of CT was 67% and the negative predictive value was 45%. CT has minimal to no utility in detecting extraprostatic disease in patients with clinically localized prostate cancer.