This observational study investigated the prevalence of prostate cancer in 345 hypogonadal men with PSA levels of 4.0 ng/mL or less, finding a 15.1% overall cancer detection rate. The prevalence increased with PSA levels, ranging from 5.6% in men with PSA ≤1.0 ng/mL to 36.4% in those with PSA 3.1–4.0