Background: Prostatic diseases are common urological conditions confronted by the urologist regularly. The clinical presentations may oftentimes be straightforward but at times challenging due to delayed patients' presentation in our setting, occasional overlap of symptoms and signs or when complications associated with the disease supervene. This study determines the difference in clinical presentations of patients histologically diagnosed with prostatic diseases among urology patients in our clinical setting. Materials and Methods: A prospective cross-sectional study conducted among 50 urology patients with indication for Transrectal ultrasound (TRUS) guided prostate biopsy at Usmanu Danfodiyo University Teaching Hospital, Sokoto, North-western, Nigeria. Data collected into a semistructured questionnaire and studied included: sociodemographic parameters, clinical symptoms and signs at presentation, International prostate symptoms score (IPSS), co-morbidities, Digital rectal examination (DRE), and histological findings. Results were analyzed using the computer software, IBM statistical package for the social sciences (SPSS) version 25 (SPSS Inc; Chicago, IL, USA). Relationships between variables were determined using Pearson's chi-square test, and Fisher's exact tests as appropriate. Results: A total of 50 patients were enrolled over the study period with a mean age of 67.32 ± 9.11 years and a range of 50-96 years. Thirty (60.0%) patients had benign prostatic hyperplasia (BPH) while 20 (40.0%) patients had prostatic adenocarcinoma (PCa). One (3.3%) patient with BPH had associated features of chronic prostatitis. The clinical presentations found to be statistically significant in favour of prostatic adenocarcinoma were weight loss, body weakness, cachexia, pallor, and abnormal digital rectal examination. Conclusion: The presence of weight loss, body weakness, cachexia, clinical pallor, and suspicious digital rectal examination at presentation are significant findings to raise a high index of suspicion of the prostate carcinoma. Hence, physicians and urologists coming in contact with prostatic disease patients should be well guided by this in our environment. Keywords: Clinical presentations, prostatic diseases, prostatitis, benign prostatic hyperplasia, prostatic adenocarcinoma