With the increasing diagnosis of prostate cancer, there have been concerns expressed regarding the potential over-treatment that may ensue following the diagnosis of localized prostate cancer. Minimally invasive treatments such as cryotherapy have been used successfully to treat the entire gland, however complications such as incontinence and erectile dysfunction can still occur. Focal cryotherapy is a modification of the standard cryotherapy technique, aiming to only treat the portion of the prostate gland which has the cancer of clinical significance. The potential advantage of this is the minimization of complications; however the remainder of the prostate is still viable and so can develop cancer subsequently. There have been several published studies demonstrating promising efficacy with a low morbidity rate using focal cryotherapy to treat prostate cancer, however further follow up is required before definitive conclusions can be reached. The appropriate selection of patients and subsequent follow up are areas needing further research and the development of improved imaging modalities.