Paraneoplastic Syndromes (PNS) are rare disorders which are caused by an altered immune response to a neoplasm. There may be the involvement of the endocrine, neuromuscular, musculoskeletal, cardiovascular, cutaneous, haematologic, gastrointestinal, renal or miscellaneous in nature. Upto 8% of the patients with cancer are affected with PNS. Prostate cancer is the second most common urological malignancy to be associated with PNS. The other are renal cell cancer. PNS secondary to the prostate cancer are a rarity. These tend to occur in the setting of the late stage and aggressive tumours and have a poor overall outcomes. PNS are associated with the serum markers that are readily detectable, which help to link the symptoms of PNS to the underlying malignancy. Histology of the prostate cancer associated with PNS frequently reveals neuroendocrine features or small cell carcinoma. Immunotherapy includes steroids, IVIg, plasma exchange, cyclophosphamide, azathioprine, rituximab, mycophenolate mofetil, methotrexate.