Background: Diagnostic staging in high-risk prostate cancer patients seeks to define the local extent of the disease as well as determine the presence of lymph nodes and distant metastases. Molecular imaging, such as PET PSMA, provides higher sensitivity and specificity for the detection of nodal and distant metastases compared to conventional imaging. ¹⁸F-PSMA-1007 is radiotracer that represents a cost-effective alternative to ⁶⁸Ga-PSMA-11, although evidence is limited. We aim to describe the performance of PSMA-1007 in the staging of patients with high risk for prostate cancer in a Latin America reference center. Methods: We performed a cross-sectional study that included prostate cancer patients who underwent ¹⁸F-PSMA1007 PET/CT for initial staging in our center of reference between 2020-2023. Descriptive analysis was performed with frequencies for discrete variables, and central tendency and dispersion measures for continuous variables. High risk was defined using the NCCN prostate cancer guidelines. Contingency tables were designed to evaluate associations between groups. To compare categorical variables, we use Chi-square and ANOVA for continuous variables. This analysis was performed using Jamovi 2.3.21 statistical software. Results: Two hundred and seventeen patients were included. The median age was 67 years. The median PSA distribution was 12 ng/ml. The most frequent Gleason group was group 4 (42,7%), followed by group 3 (25,5%). The most prevalent results on the PET pattern are presented in Table. 32% of the patients presented positive lymph node findings. Before the F-PSMA 1007 PET/CT, 24% of the patients had lymph node involvement identified and 33.2% had negative lymph nodes with conventional imaging. These values changed to 39% and 56% respectively, with the F-PSMA 1007 PET/CT. Bone was the most frequent metastasis site (14,3%), followed by extrapelvic lymph node metastasis (12%). A favorable correlation between higher PSA levels and stratified risk assessment by PSMA pattern was evident (p< 0.001). Conclusions:¹⁸F-PSMA-1007 is an innovative radiotracer that can be used to evaluate the extension of prostate cancer involvement. Future studies with prospective cohorts should be carried out to establish analyses between ¹⁸F-PSMA-1007 use and its influence on the oncological management of these patients.