Metastatic spread of prostate adenocarcinoma to the temporal bone is rare. Involvement the jugular foramen may result in Collet-Sicard syndrome. This extremely uncommon clinical entity is characterized by paralysis of the lower four cranial nerves. A case of metastatic prostate adenocarcinoma involving the temporal bone causing a Collet-Sicard syndrome associated with an ipsilateral lower motor facial palsy and a mixed sensorineural and conductive hearing loss is presented. This case highlights the potential of prostate adenocarcinoma to cause symptoms referable to the temporal bone region and histopathologic analysis of biopsy material should include immunohistochemical staining for prostate specific antigen.