Background <p>To assess long-term trends in mortality and disease burden from prostate cancer in Albania during 1990–2023 in comparison to other Southeastern European countries and broader European regions.</p> Materials and methods <p>An analysis of mortality and morbidity estimates of prostate cancer was conducted based on data available from the Global Burden of Disease (GBD) studies. Crude and age-standardized mortality rates, proportional mortality, and Disability-Adjusted Life Years (DALYs) of prostate cancer were analysed for Albania. Furthermore, age-standardized estimates of Albania were compared with Southeastern European countries and with Eastern, Central, and Western European regions.</p> Results <p>From 1990 to 2023, prostate cancer mortality and DALYs in Albania increased modestly in absolute terms, whereas age-standardized rates remained relatively stable. Conversely, proportional mortality and DALYs increased, due to population ageing. Compared with Southeastern Europe, Albania exhibited lower or comparable age-standardized rates, with smaller increases than several neighbouring countries. By 2023, Albania’s prostate cancer burden, which increased modestly since 1990, remained nevertheless the lowest across European regions, despite Western Europe’s sharp decline.</p> Conclusion <p>Notwithstanding the lowest burden in Europe, prostate cancer in Albania exhibits a growing proportional impact on public health which is a cause of concern. Importantly though, Albania’s lowest prostate cancer mortality and disease burden compared with all European regions may reflect under-reporting, warranting extreme caution in interpreting its comparatively favourable position and highlighting the importance of strengthening cancer surveillance and prevention strategies to ensure accurate monitoring and sustained public health gains.</p>