The Uro-Oncological community has been aware of racial differences in prostate cancer (PCa) incidence and treatment outcomes for many years. In the USA, the lifetime risk for African American (AA) men dying from PCa is twice that of Non-Hispanic White (NHW) men. Since the observation was first made, potential causes have been suggested as socio-economic, including the influence of comorbidities, differences in tumor biology, or some combination of both. Interestingly, two recent studies found that once socioeconomic issues were equalized, differences in treatment outcomes were eradicated. Dess et al. (2019)1 examined 306,100 patients with localized or locally advanced PCa from Surveillance, Epidemiology and End Results (SEER), Veterans Affairs (VA) Health System, and 4 pooled National Cancer institute Radiation Therapy Oncology Group phase 3 randomised controlled trial databases, over 55,482 (18.1%) of whom were AA men. Once treatment was standardized, and healthcare access issues resolved, stage for stage PCa mortality in AA men was not significantly different to NHW men, although other cause mortality rates remained higher.