Aim: To determine the clinicopathologic pattern of prostatic diseases in patients from the Northern sector of Ghana, with emphasis on prostate cancer (PCa). Methods: The medical records on patients who underwent histological examinations of their prostate at the Komfo Anokye Teaching Hospital from 2008 to 2015 were examined retrospectively. The age, indications for biopsy, histological diagnosis and Gleason grading of cancer patients, were also studied. Results: The study included 225 patients aged between 40-97 years with (median and mean (sd):71 and 70.8(9.1) years respectively). Specimens included 158 transrectal ultrasound (TRUS) guided biopsies, 41 transurethral resection of the prostate (TURP), 26 simple prostatectomies. Indications for the TRUS guided biopsy in 96 patients were (53.5%) elevated prostate specific antigen (that is PSA >4.0 ng/ml). (19.7%) and (26.8%) abnormal digital rectal examination or both. Prostate specific antigen values ≤ 4 ng/ml were found in (18.8%) of the patients. From the examination of 225 prostatic specimens, Adenocarcinoma accounted for (75.1%), benign prostatic hyperplasia (BPH) alone was (19.1%), BPH with prostatitis/inflammation (3.6%), prostatitis alone (1.8%) and Squamous metaplasia (0.4%). Among other findings, incidental PCa was detected in 37/67(55.2%) of specimens that was performed using either of simple prostatectomy or TURP for patients in whom a clinically-benign prostate disease was expected. Within the entire prostate cancer patients, Gleason score ≥6 was found in 163/169 (96.5%). Conclusions: The incidence of prostate diseases, particularly prostate cancer among the aging males in the Northern sector of Ghana, like other sub-Saharan countries is high. This is evidenced by the high proportion of incidental PCa detected in patients in whom a prostatectomy was done for a previously-assumed benign prostate disease (55.2%). Future studies on the subject is recommended to help ascertain its predisposing factors

Keywords: Benign prostate, prostate cancer, Early Detection, Transrectal ultrasound, Gleason score