Objective To investigate the levels of fatigue, pain and quality of life in patients with metastatic castration-resistant prostate cancer (mCRPC), and to analyze the influencing factors of quality of life.Methods A total of 127 patients with mCRPC were surveyed by using the Brief Fatigue Inventory, Brief Pain Inventory and the Functional Assessment of Cancer Therapy-Prostate (FACT-P) at baseline and 2, 4 and 6 months after recruitment.Results Fatigue at baseline, 2, 4 and 6 months after recruitment scored 2.20, 2.46, 2.20, and 2.80 respectively, pain scores were 1.66, 1.87, 1.95, and 2.10, and quality of life scored 90.58,90.23,89.22, and 88.88, respectively, each showing significant differences over time (P＜0.01 for all).Treatment methods, Eastern Cooperative Oncology Group (ECOG) score, fatigue, pain, and age were factors affecting quality of life (P＜0.01 for all).Conclusion As the disease progresses, fatigue and pain become more severe, and quality of life decreases.Nursing staff should pay attention to and identify impaired quality of life of patients at early stage, and intervene early.