BACKGROUND Prostatic neoplasia (BPH and CaP) are common urological problems, with significant morbidity and mortality. A review of the literatures reveals that these diseases show considerable geographical, racial, and even ethnic variations in their patterns of presentation, OBJECTIVE To study the pattern of prostatic neoplasia in terms of incidence, BPH:CaP ratio, clinical presentations, histological features, as well as the treatment modalities employed in the management of these diseases in this locality. METHOD A prospective study of one hundred and ten consecutive male patients presenting with LUTS, in whom a diagnosis of BPH or CaP was made, was carried out over a period of twelve months, at the Ebonyi State University Teaching Hospital and the Federal Medical Centre, both in Abakaliki. Diagnosis was by digital rectal examination, serum PSA assay, abdomino-pelvic ultrasound scan, and prostate biopsy where indicated. The data were collated in a proforma and analysed. RESULTS Out of the one hundred and ten patients studied, eighty five (77.3%) had BPH while twenty five (22.7%) had CaP, giving a BPH: CaP ratio of 3.4 : 1, and a hospital incidence of 212/100,000 for BPH and 62/100,000 for CaP. Although the BPH : CaP ratio and the BPH incidence are similar to reports from other parts of Nigeria, the CaP incidence is relatively low in this locality. As in most other parts of the developing world, all the patients with CaP presented with the late stages of the disease which were all adenocarcinomas histologically. Irritative and obstructive LUTS were the commonest presenting features in both BPH and CaP. Urinary retention occured in 52.9% (n=45) and 72.0% (n=18) of the patients with BPH and CaP respectively. Macroscopic haematuria was observed in 21.2% (n=18) of those with BPH and in 16.0% (n=4) of those with CaP. Patients with BPH were managed by watchful waiting in 5.9% (n=5) of cases, medical therapy in 27.0% (n=23) of cases, transvesical prostatectomy in 31.8% (n=27) of cases, while 35.3% (n=30) were on intermittent catheter drainage awaiting surgery. Because all the patients with CaP presented with the late stages of the disease, they were all managed palliatively by various forms of androgen deprivation therapy. CONCLUSION Prostatic neoplasia are common afflictions of men in this locality. Their pattern of incidence, clinical and histological presentations, and BPH:CaP ratio, compare favourably with findings reported in other parts of Nigeria and other developing parts of the world. A relatively low incidence of CaP was however observed. Creation of public awareness and the institution of a screening program are necessary to enhance early presentation and detection of CaP, as this will significantly improve the prognosis of this disease