PURPOSE Prostate cancer is the second leading cause of cancer mortality in males globally. Diagnosis is commonly achieved via trans-perineal or trans-rectal needle biopsy. While complications such as haematuria, and urinary tract infections are well-documented, tumour seeding along the biopsy tract is a relatively rare occurrence. In this case, we present a 68 year old gentleman with rising PSA levels following robotic radical prostatectomy and salvage prostatectomy. We aim to demonstrate a case of tumour seeding with a considerable time lag between the primary malignancy and the distant metastasis. METHODOLOGY This case was retrospectively reviewed using the patient’s electronic medical records, including blood test results and histopathology reports from previous biopsies. All relevant investigations pertaining to his prostate cancer were meticulously analysed to support this case presentation. RESULTS The patient was initially diagnosed with high-risk prostate cancer. He underwent robotic-assisted radical prostatectomy and required salvage radiotherapy in 2021. A PSMA PET scan was performed, revealing tracer uptake at the base of the penis. It was assessed that this area likely represented an isolated solid recurrence. An open excision of the perineal nodule was performed, which demonstrated prostatic adenocarcinoma matching the histological characteristics of the original malignancy. CONCLUSION Tumour seeding is an uncommon but significant complication of prostate biopsies. This case is particularly noteworthy due to the prolonged interval between the initial prostate cancer diagnosis and the emergence of metastatic disease. This highlights the need for vigilance in long-term follow-up of prostate cancer patients.