The principal aim of the study was to investigate the role of individual characteristics in decisional conflict of patients with prostate cancer (PCa) in order to identify risk and protective features. An observational study was conducted with 83 PCa patients accessing the multidisciplinary visit of Prostate Cancer Program at Fondazione IRCCS Istituto Nazionale dei Tumori in Milan. The multidisciplinary visit (MDV) consists in two separate but interrelated parts: the medical consultation and the psychological consultation, which includes decision-making counseling. Patients’ decisional conflict was measured before entering the visit and two weeks after. Results underlined that decisional conflict decreased in the follow-up. Furthermore, perceived self-efficacy partially predicts a decrease in decisional conflict thus representing a protective factor while buck-passing defensive decisional style partially predicts an increase in decisional conflict thus representing a risk factor. To conclude, future interventions aiming to cope with PCa treatment decisional conflict might incorporate activities designed to boost decision-making self-efficacy.