Our study evaluates the association between prostate cancer and exposure to pesticides in agricultural settings in Italy. The data were derived from a hospital‐based multi‐site case‐control study carried out in 5 rural areas between 1990–92. In our study, 124 new cases of prostate cancer were ascertained and interviewed, along with 659 cancer controls. A team of agronomists assessed past exposure to pesticides by using a checklist of 100 chemical families and 217 compounds applied from 1950–85 in the areas considered. The association between prostate cancer and different occupational risk factors was measured by maximum likelihood estimation of the odds ratio, controlling for potential confounders. “Ever been employed in agriculture” was associated with a 40% increased risk (OR = 1.4, 95% CI = 0.9–2.0). Prostate cancer was also related positively to food and tobacco (OR= 2.1, 95% CI = 1.1–4.1), and chemical products (OR = 2.2, 95% CI = 0.7–7.2) industries. The analyses carried out to estimate the association between different types of pesticides and prostate cancer showed increased risks among farmers exposed to organochlorine insecticides and acaricides (OR = 2.5, 95% CI = 1.4–4.2), more specifically to the often contemporary used compounds DDT (OR = 2.1, 95% CI = 1.2–3.8), and dicofol (OR = 2.8, 95% CI = 1.5–5.0), whose effects could not be well separated. © 2003 Wiley‐Liss, Inc.