Background: We previously reported the effects of the PSA screening guidelines on the patterns of diagnosis and treatment for PCa based on analyses from the NCDB dataset (Aragon-Ching et al., ASCO GU 2016). Given increasing use and advocacy for active surveillance, we now report on the treatment utilization patterns for PCa by facility type and overall incidence of active treatment (surgery or radiation), no treatment, or active surveillance by PCa stage using the NCDB dataset. Methods: Using a de-identified dataset acquired from NCDB from 1998 to 2012, treatment status of all 337,568 men for which information was available was tabulated according to whether active treatment, no treatment, or active surveillance (i.e. watchful waiting) was performed. Patient characteristics, stage, and treatment status by facility type was determined. Results: There were 1,802,596 patients diagnosed with prostate cancer between 1998 and 2012 in the NCDB. Of the 337,568 men for which treatment status was available, 92% received treatment, nearly 4% were under active surveillance, and another 4% did not receive any form of treatment or active surveillance. Of patients diagnosed with TNM Stage I and II PCa, only 7.5% and 2.22%, respectively, were followed under active surveillance. Overall, active surveillance was most utilized (n = 7,524; 5.7% of men) in academic research programs compared to other treatment facilities. Of the 310,898 men who received any form of active treatment, 193,889 men (62.3%) received surgery and 108,925 men (35%) received radiation. Conclusions: Active surveillance as a treatment modality comprised only a minority of patients who underwent treatment for PCa from 1998–2012, even among men with early Stage I and II Pca. Interestingly, the majority of the men who did receive active surveillance as their treatment option were treated at academic research programs, perhaps alluding to increased recognition and adherence to the PSA screening and active surveillance guidelines compared to other treatment facility types. Datasets including PCa patients beyond 2012 will be explored to further evaluate these changes in treatment modalities.