The global epidemiology of prostate cancer is increasingly significant due to the aging male population and rising incidence rates. Prostate cancer is now the fifth leading cause of cancer death among men, with over one million new cases diagnosed annually and more than 300,000 deaths each year. It has surpassed esophageal cancer in male mortality burden. Incidence and mortality rates vary greatly across regions and populations, influenced by genetic, dietary, lifestyle, environmental, and healthcare access factors. This special issue of the World Journal of Urology explores various aspects of prostate cancer epidemiology. Auvinen et al. examine national-level variations in prostate cancer incidence using GLOBOCAN data, focusing on medical expenditure intensity. Akaza et al. review the evolving epidemiology of prostate cancer in East Asia, where incidence and mortality have historically been low. Peisch et al. discuss diet and lifestyle factors, emphasizing exercise and smoking cessation. Stopsack et al. critique the literature on medications like metformin and statins affecting prostate cancer risk. Albanes et al. explore the impact of vitamins and micronutrients. Nordström et al. comment on potential changes in prostate cancer screening policies based on the STHLM-3 trial. These articles aim to stimulate research into the genetic and environmental factors influencing prostate cancer risk and mortality. Understanding these variations can provide deeper insights into the disease's biology, benefiting men at risk globally.The global epidemiology of prostate cancer is increasingly significant due to the aging male population and rising incidence rates. Prostate cancer is now the fifth leading cause of cancer death among men, with over one million new cases diagnosed annually and more than 300,000 deaths each year. It has surpassed esophageal cancer in male mortality burden. Incidence and mortality rates vary greatly across regions and populations, influenced by genetic, dietary, lifestyle, environmental, and healthcare access factors. This special issue of the World Journal of Urology explores various aspects of prostate cancer epidemiology. Auvinen et al. examine national-level variations in prostate cancer incidence using GLOBOCAN data, focusing on medical expenditure intensity. Akaza et al. review the evolving epidemiology of prostate cancer in East Asia, where incidence and mortality have historically been low. Peisch et al. discuss diet and lifestyle factors, emphasizing exercise and smoking cessation. Stopsack et al. critique the literature on medications like metformin and statins affecting prostate cancer risk. Albanes et al. explore the impact of vitamins and micronutrients. Nordström et al. comment on potential changes in prostate cancer screening policies based on the STHLM-3 trial. These articles aim to stimulate research into the genetic and environmental factors influencing prostate cancer risk and mortality. Understanding these variations can provide deeper insights into the disease's biology, benefiting men at risk globally.