Background: Socioeconomic class (SEC), measured by educational attainment, is recognized as a notable factor influencing outcomes in prostate cancer. This study evaluated the effects of income status on the prevalence, treatment, and hospitalization outcomes among men diagnosed with prostate cancer. Methods: The combined 2016–2020 nationwide inpatient sample database was queried for all hospitalizations for a primary diagnosis of prostate cancer using ICD-10-CM codes. Socioeconomic status was defined based on the Agency for Healthcare Research and Quality (AHRQ) median annual income index into the lowest SEC ($1–$49,999), the lower SEC ($50,000–$64,999), the high SEC ($65,000–$85,999), and the highest SEC ($≥86,000). Baseline characteristics were compared using Pearson’s χ2 tests and the Kruskal-Wallis test for nominal and continuous variables. Outcomes of interest were hospitalization rates, treatment, and outcomes (including mortality, complications, and resource utilization). The adjusted odds ratios of the outcomes were assessed using a stepwise multivariable logistic regression, adjusted for age, sex, race, insurance status, illness severity, risk of mortality, and comorbidity burden. This was done using the All Patient Refined Diagnosis Related Groups (APR-DRG) metrics and the Charlson comorbidity index. Results: The study analyzed 244,520 hospitalizations for prostate cancer. The median age of the cohort was 64 years (interquartile range: 59–69 years). Most were white Americans (69.9%) and blacks (16.3%). Approximately 53,550 (21.9%) were in the lowest SEC, 58,196 (23.8%) were in the lower SEC, 61,619 (25.2%) in the high SEC, and 66,803 (27.3%) in the highest SEC. Hospitalizations in the highest SEC were younger than those in the lowest SEC (63.7 vs. 66.5; P<0.001). Hospitalizations in the lowest SEC were correlated with greater mortality (655, 1.2%; AOR: 1.43; 95% CI: 1.22-1.56; P=0.011) compared with those in the highest SEC (475, 0.7%; AOR: 0.86; 95% CI: 0.65-0.97; P<0.001). The highest SEC correlated with higher rates of prostatectomy (2,995, 4.5%; AOR: 1.29; 95% CI: 1.08-1.10; P<0.001), whereas the lowest SEC had lower rates (1,810, 3.4%; AOR: 0.52-0.98; P=0.008). The lower and lowest SECs had higher frequencies of chemotherapy (8.1% and 7.4%, respectively; P for all <0.001). SEC did not correlate with the likelihood of immunotherapy (P = 0.738), radiotherapy (P = 0.073), length of hospital stays (P = 0.283), or mean hospital costs (P = 0.582). Hospitalizations in the higher SECs had lower odds of erectile dysfunction (highest SEC, AOR: 0.83; 95% CI: 0.74-0.93; P = 0.001; and high SEC, AOR: 1.13; 95% CI: 1.02-1.24). Conclusions: Prostate cancer affects the younger demographics of patients with higher SECs. However, hospitalizations in patients with lower SECs present with more advanced disease and result in poorer mortality outcomes than those in patients with higher SECs.