An age-stratified population-based random digit dial (RDD) telephone survey determined awareness and prevalence of prostate-specific antigen (PSA) testing among Alberta men aged 40 74 years, and assessed the role of indications for PSA testing in explaining patterns of PSA testing. The sample of 1984 men (participation rate 65%) with no history of prostate cancer was divided into three age strata: 40-49, 50-59, and 60-74 years. Awareness of PSA tests was low with fewer than half of the men indicating they had ever heard of PSA tests. The percentage of men who had ever had PSA testing was 4.5%, 13.1%, and 22.2% in the three age strata respectively. PSA testing was strongly associated with having at least one clinical indication for PSA testing (prevalence 21.8%, 26.9%, and 42.2% respectively). PSA testing rates were very low among men who had no clinical indications for PSA testing, suggesting infrequent PSA screening prior to the survey. PSA testing patterns in this population-based sample were consistent with Alberta clinical practice guidelines.