IntroductionThis report is intended to provide insight into the presentation, diagnosis, and treatment of prostatic sarcomas. A literature review is included to compare variables in demographics, histology, prognosis, and treatment strategies among previously reported incidences.Case presentationIn this case, we have a 72‐year‐old man who initially presented with symptomatic nephrolithiasis that led to further workup. Magnetic resonance imaging revealed an enlarged, heterogeneous prostate with a dominant mass in the left lobe. A biopsy of the prostate revealed a high‐grade, undifferentiated sarcoma in the left lobe along with concomitant adenocarcinoma in the right lobe.ConclusionsThe patient underwent a radical prostatectomy, which according to existing literature remains the most effective treatment strategy. Staging is the most important prognostic indicator, making this cancer particularly dangerous as presenting symptoms are highly variable among patients.