Background: While prostate cancer mortality has declined in the in the general population, it remains high in African Americans. The aim of our study is to determine whether race and insurance type affect treatment outcomes in prostate cancer patients at our institution. Methods: A retrospective chart analysis between 2012 and 2017 of 2763 prostate cancer patients was done at our institution. We collected data on age, race, stage, insurance, treatment history, date of diagnosis, Gleason score, date of death. The healthcare insurance information was categorized into Medicare with and without supplement, VA, Medicaid, no insurance/self- pay, City Contract and private. City Contract is the city sponsored health care access for person with low income living in the Duval County. Univariate and multivariate chi square analysis with odd ratio was performed, 95 % confident intervals were evaluated with P value < 0.05. Results: African Americans were 2.93 times more likely to experience death than Caucasians (Odds Ratio, OR, 1.79-4.78, 95 % CI). Both Private and VA insurance were more likely to have a lower stage of prostate cancer compared to City Contract (0.53 times, 0.30-0.93, and 0.411 times, OR 0.23-0.84 95 % CI respectively). African Americans were significantly more likely to have a more advanced cancer stage when compared to Caucasians (1.85 times, 1.49 -2.29 95 % CI). Every insurance type was significantly less likely to undergo surgery compared to City Contract. All except Medicaid, were more likely to undergo radiation compared to City Contract. African Americans are more likely to undergo surgery (2.68 times, 2.01-3.56, 95% CI) and were less likely to have radiation or chemotherapy when compared Caucasians (0.25 times, 0.20-0.31 95% CI). Conclusions: Disparities in race and insurance type can affect the stage at presentation, type of treatment received and survival.