With the emergence of new imaging and implant techniques, prostate brachytherapy has become increasingly popular over the last decade. Brachytherapy promises to deliver twice the biologically effective dose as conventional external beam treatments without increasing the dose to tissues surrounding the prostate. However, there are few or no published Australian series of its efficacy in the clinic. We present the experience of one of the first centres in Australia to offer this service to its patients: a series from Sir Charles Gairdner Hospital in Western Australia. We present data on the efficacy of brachytherapy in maintaining prostate specific antigen levels, as well as the rate of urinary, rectal and sexual complications. Our results compare favourably with other brachytherapy and external beam treatment series. We believe that with the increasing trend towards dose escalation and novel therapies, standardized measurements of success and failure need to be better defined, and that randomized trials comparing modalities are needed to improve the management of prostate cancer.