Laparoscopic pelvic lymphadenectomy is a satisfactory alternative to open lymphadenectomy for staging prostate cancer. Specific information obtained by endorectal coil magnetic resonance imaging may be used to predict the most likely side for lymph node metastases. These criteria may be used to define side selection for performing a unilateral laparoscopic lymphadenectomy without the risk of missing contralateral nodes that may be positive. A unilateral dissection when feasible reduces operative time and morbidity.