Case study of a patient with evidence of a prostate-specific membrane antigen (PSMA)-avid prostatic finding in the initial staging with an initial prostate-specific antigen of 13.0 ng/mL, concordant with the histopathologically confirmed aggressive prostate carcinoma (PC) with a Gleason Score of 8 (4 + 4). The [68Ga]Ga-PSMA-11 positron emission tomography/computed tomography showed five locoregional lymph node metastases (blue arrows) carrying intensive tracer uptake (the highest maximum standardized uptake value of 19.4), which were histopathologically confirmed as metastatic PC.