Objective: This study aimed to investigate the effectiveness of first-line treatments and survival-related prognostic factors in castration- resistant prostate cancer (CRPC) with isolated bone metastasis. Material and Methods: Clinicopathological characteristics of patients diagnosed with CRPC and isolated bone metastasis presenting to the Medical Oncology Clinic of Dicle University between January 2010 and December 2020, as well as the treatments received by them, were retrospectively evaluated. Results: Our study included 91 prostate cancer patients that were in the castration-resistant stage and had isolated bone metastases. As the first-line treatment, 43 (47.2%) of our patients received docetaxel (DOC), 27 (29.6%) received abiraterone acetate (AA), and 21 (23.2%) received enzalutamide (ENZA). The median progression- free survival (PFS) periods for the DOC, AA, and ENZA groups were 9 months [95% confidence interval (CI): 6.52-11.47], 8 months (95% CI: 3.54-12.45), and 13 months (95% CI: 8.09-17.90), respectively (p=0.047). The median overall survival (OS) periods among patients receiving DOC, AA, and ENZA during the hormone-refractory period were 13 months (95% CI: 8.48-17.51), 12 months (95% CI: 8.58- 15.41), and 20 months (95% CI: 2.90-37.09), respectively (p=0.13). Multivariate analyses indicated that the choice of first-line treatment received by the patients was an independent prognostic factor for PFS, whereas lymph node metastasis was an important prognostic variable for OS. Conclusion: Our study involving CRPC patients with isolated bone metastases demonstrates similar OS among patients receiving DOC, ENZA, or AA as the first-line treatment for prostate cancer, although ENZA is associated with a better PFS.