The chapter reviews the accuracy of 18F-fluciclovine (FACBC) PET/CT in detecting recurrent prostate cancer when other old imaging methods (e.g., choline PET or conventional CT/MRI) fail. The high specificity in preoperative lymph node staging highlights its reliability in confirming positive cases, though the lower sensitivity suggests that it might not detect all metastatic nodes. The FDA and EMA approved in 2022 18F-fluciclovine only for recurrent PCa, but other data supports its use in high-risk primary cases. The meta-analyses show that 18F-fluciclovine PET/CT demonstrates promising diagnostic accuracy in various clinical settings, particularly in detecting recurrent prostate cancer and staging lymph nodes. FACBC remains an important tool in managing prostate cancer, especially in the context of biochemical recurrence. Multiple illustrative patient cases are shown.