Sixth nerve palsy is frequently due to infectious orbital lesions, trauma, elevated intracranial pressure, brainstem lesions, and vasculopathies. Here, we describe a rare cause of sixth cranial nerve (CN) palsy secondary to calvarial and orbital metastasis of prostate carcinoma. The diagnosis of the prostate carcinoma with sixth CN palsy is a very rare condition. A 66-year-old male patient presented with complaints of blurred vision, double vision, and inability to move outward in the right eye for 3 weeks. Magnetic resonance imaging revealed a right orbitocalvarial mass and the mass surgically removed completely. Pathologic findings were compatible with prostate adenocarcinoma metastasis. After surgical removal, significant improvement in sixth CN palsy was observed.