Prostate cancer is a significant public health problem with African ancestry and increasing age being significant risk and prognostic factors. Quite rare before the age of 40 years, challenges of prostate cancer at this age group includes disease detection at advanced stage and a poor relative 5-year survival. We describe a case of high-grade prostate cancer in a male under 40 years old with metastatic disease at the time of diagnosis, and highlight the need for thorough investigation of urinary and erectile symptoms at this age. We further advocate for increased primordial and primary prevention strategies in the fight against cancers.