Background: Several lifestyle factors have been independently associated with prostate cancer progression and mortality, but little is known about their combined effect.Our objective wasto develop scores based on post-diagnostic diet and lifestyle behaviors for the prevention of prostate cancer death. Methods: We developed four scores (food-only: range 0-5; food & drinks: range 0-8; lifestyle-only: range 0-3; food, drinks & lifestyle: range 0-11) among 3,583 men in the Health Professionals Follow-Up Study diagnosed with non-metastatic prostate cancer in 1986-2008 with follow-up through 2012. Potential factors and their cut-points were based on the literature. One point was given for each factor: not currently smoking or quit ≥ 10 years ago, BMI < 30 kg/m², ≥ 3 h/wk vigorous activity or ≥ 7 h/wk brisk walking, ≥ 1 serv/d cruciferous vegetables, ≥ 3 serv/wk nuts or oil-based dressings, ≥ 4 cups/d coffee, ≥ 7 serv/wk wine, < 2 serv/wk processed meat, 0 serv/wk poultry with skin or poultry sandwiches, and < 140 ug/d of supplemental selenium. We used multivariable Cox proportional hazards regression. Results: We observed 240 prostate cancer deaths during a median of 11 years follow-up. A 1-unit increase in each score was associated with a similar reduction in risk of prostate cancer death: food-only (HR = 0.71; 95%CI = 0.60,0.85); food & drinks (HR = 0.71; 95%CI = 0.61,0.82); lifestyle-only (HR = 0.72; 95%CI = 0.56,0.92); and total diet & lifestyle (HR = 0.71; 95%CI = 0.63,0.81). Men with 3 vs 0-1 points for the lifestyle-only score had a 51% decreased risk of prostate cancer death (95%CI = 0.28,0.83); men with ≥ 5 vs 0-2 points on the food & drinks score had a 73% decreased risk of prostate cancer death (95%CI = 0.14,0.51); and men with 4-7 and 8-11 vs 0-3 points for the total diet & lifestyle score had a 48% (95%CI = 0.32,0.84) and 75% (95%CI = 0.09,0.69) decreased risk of prostate cancer death. Conclusions: Adhering toa lifestyle characterized by frequent vigorous activity; not smoking; a healthy weight; a diet rich in cruciferous vegetables, healthy fats from vegetable sources, coffee, and wine and low in processed meat and poultry with skin; and avoiding excess supplemental selenium after prostate cancer diagnosis may lower risk of prostate cancer death.