Objective To investigate the therapeutic effect of conventional-dose bicalutamide at 50 mg/d in Chinese male with androgen independent prostate cancer (AIPCa). Methods Forty-four eligible AIPCa cases were treated with bicalutamide at 50 mg/d as the second-line hormonal therapy. Serum prostate-specific antigen (PSA) was taken as the primary determinant for treatment outcome assessment. Treatment response was defined as PSA reduction over 50%. The presence of adverse events was also evaluated. Results The conventional-dose bicalutamide was in general well tolerated without severe adverse event. The overall treatment response rate was 38.6% (17/44) with median duration time of 5 months. Patients with the presence of flutaminde withdrawl syndrome (FWS) and lower PSA entry level (≤20 ng/mL) showed significantly higher treatment response rate than others (64.7% vs. 7.4%, 61.1% vs. 23.1%). In addition, Kaplan-Meier survival curves for patients stratified according to the presence of FWS and PSA entry level showed that the absence of FWS and higher PSA entry level (>20 ng/mL) was significantly associated with mortality risk (P=0.044 9, 0.025 2). Conclusions Conventional-dose bicalutamide at 50 mg/d as the second-line hormonal treatment can achieve credible treatment outcomes in Chinese AIPCa patients. The presence of FWS and PSA entry level might be considered as independent factors for predicting treatment effect and survival rate.