Neuroendocrine prostate cancer (NEPC) is a highly malignant subtype of prostate cancer and it mostly occurs in castration-resistant prostate cancer patients after antiandrogen therapy. The process of cell differentiation to obtain neuroendocrine phenotypes is called neuroendocrine differentiation (NED). It is a proposed mechanism of prostate cancer resistance to androgen-resistance therapy, which is associated with poor prognosis. At present, there is no consensus on the physiological and pathological characteristics of NEPC, and the treatment of this subtype is particularly difficult. This paper reviews the latest findings related to NEPC and NED, and summarizes the most studied targets, hoping to provide new ideas for peer diagnosis, treatment and research of NEPC.