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OBJECTIVE To determine whether the immune score and methylation levels of transcription factor 21 (TCF21) could be used as independent diagnostic indicators and prognostic predictors in prostate cancer (PCA). STUDY DESIGN A descriptive study. PLACE AND DURATION OF STUDY Department of Urology, Quanzhou First Hospital Affiliated to Fujian Medical University, from November 2017 to December 2019. METHODOLOGY Cases of PCA were for numbers of CD3+ and CD8+ T lymphocytes in the nests and stromal regions of PCA tissues. The percentage of CD8+ T lymphocytes in the peripheral blood was measured. TCF21 methylation was detected. The patient samples were classified according to risk-factor level, the immune score and TCF21 methylation levels were subsequently determined. The time of effective hormone therapy was calculated. The relationships among immune score, TCF21 methylation level, PCA risk-factor level and the time of effective hormone therapy were determined. RESULTS There was no significant difference of the proportions of CD8+ T cells in the peripheral blood between different T stage groups and different Gleason scores groups. The authors found negative linear relationships between immune score and risk-factor level, PSA level and Gleason score (p <0.001). The linear relationship of the immune score with T stage was not significant (p >0.05). The immune score correlated with the time of effective hormone therapy (p =0.002). There was significant correlation between TCF21 methylation and PSA, Gleason score, risk-factor level and immune score (p <0.05).There was also no significant correlation between TCF21 methylation and T stage (p >0.05). CONCLUSION The immune score and TCF21 methylation could be used as independent indicators for the diagnosis and prognosis of PCA. Key Words: Prostatic neoplasms, Immunity cellular, DNA methylation.