Introduction: Given the increasing number of patients surviving long-term after prostate cancer and the range of treatment options, all of which may lead to side effects, this study evaluated health-related quality of life 10 years after treatment in patients with localized prostate cancer, compared with age-matched controls. Method: The patient population was drawn from cancer registries; controls were recruited from the general population and matched by age. A self-administered questionnaire was used to measure quality of life, anxiety, and fatigue. Patients were classified into three groups based on their initial treatment: radical prostatectomy (RP), radiation therapy (RT), and combined treatment (RP+RT). Health-related quality of life (HRQoL) was assessed in patients compared to controls and by treatment. Results: There were no sociodemographic differences between patients and controls (N=287). They had similar levels of overall HRQoL, anxiety-depression, and fatigue. Regardless of treatment, patients reported more urinary disorders (function and incontinence) (p<0.0001) and sexual dysfunction (p<0.0001) than controls. Groups treated with RT (alone or combined with surgery) had more functional bowel disorders (p<0.0001 and p=0.002), but only those in the PR+RT group reported bowel discomfort. The PR groups had the most urinary disorders (all p<0.01), and the PR+RT groups reported the most intestinal discomfort. Conclusion: Ten years after treatment, patients have an overall QoL comparable to that of controls, but they experience more urinary and sexual dysfunction. Patients who received combination therapy have cumulative sequelae.