Lymphatic drainage from the prostate is mainly directed towards pelvic sentinel lymph nodes, although presacral and para-aortic sentinel nodes have also been found with lymphatic mapping. In this case series, we describe direct lymphatic drainage towards the anterior abdominal wall in 3 patients with prostate cancer. In one patient, the sentinel node at the anterior abdominal wall contained metastasis. Sentinel node sampling provides the possibility to map all nodes on a direct drainage pathway, in contrast to regional pelvic nodal dissection with which some sentinel nodes may be missed.