This paper is a consensus statement from a diverse global group of prostate cancer (PCa) experts, research professionals, and men with living experience of the current best practice and priorities for active surveillance (AS). The panel members assessed 307 AS practice statements and identified and ranked potential research priorities. Gleason grade and magnetic resonance imaging (MRI) findings were identified as the most important criteria for offering AS and there was a strong consensus on recommending an MRI-guided AS strategy. Mandatory protocol-based biopsies could be avoided in cases with stable MRI and prostate-specific antigen (PSA) findings, and changes in PSA and/or digital rectal examination (DRE) should prompt MRI ± biopsies rather than immediate treatment. Furthermore, the highest research priority was the development of a personalised, dynamic, and risk-adapted AS strategy, preferably with less testing in men with the lowest risk of progression.