Metastasis to the brain from prostate carcinoma is a rare event, having been reported in less than 5% of postmortem examinations. The incidence of cases detected antemortem is even smaller, and the incidence of brain metastasis as the only site of metastasis has been reported in only one other case. The authors present a second such case of a patient with a Stage C adenocarcinoma of the prostate that metastasized to the brain stem; this was the only site of spread.