BACKGROUND: Prostate cancer continues to be a major public health issue and efforts to address the global prostate cancer disparities in Black males are met with many challenges, specifically in developing nations. OBJECTIVE: To show that prostate cancer is common cause of morbidity, mortality and to analyse the pattern of distribution of the disease. METHODS: This is a 4-year retrospective histopathological analysis of prostate cancer specimens diagnosed between January 2006-December 2009 in the Department of Pathology, Federal Medical Centre, Keffi, Nasarawa State. Haematoxylin & Eosin (H&E) stained histology slides were retrieved and studied. The slides were reviewed by two consultant pathologists blinded; they were in agreement over the diagnosis. The parameters studied were histological type of cancer, patient's age and the trend over a 4-year period. After histological assessment, the tumour was classified according to WHO recommendation. Histological grading and scoring of adenocarcinoma was done using Gleason System. RESULTS: Forty-One (41) cases of prostate cancer were reviewed during the period of study. The surgical procedure were prostatectomy 23 (56%) and trucut biopsy 18 (44%). The age range was between 50-89 years with a mean of 69.5 years. The peak age at diagnosis was in the eighth decade. Most of the adenocarcinoma in this analysis was incidental carcinoma as most of the patients were thought to have nodular hyperplasia, but they were found to have adenocarcinoma on histological examination. The Gleason scores range from 4 to 10. There were 7 (17%) cases of well differentiated-, 22 (53.7%) patients had moderately differentiated-, while 12 (29.3%) patients had poorly differentiated adenocarcinoma. No other histological types were seen. CONCLUSION: Though a lot had been done to improve the quality of care of patients with prostate cancer, there is still much to done in developing countries as most of the recent available modalities of treatment cannot be accessed due to a high cost and lack of access to health insurance.