Pseudoepitheliomatous, keratotic and micaceous balanitis (PKMB) is a non-venereal and extremely rare pre-malignant condition characterized by silvery white plaque with micaceous scaling on glans seen in elderly uncircumcised men. Symptoms include phimosis, pain, and interference with sexual activity. Herein we present a young, 40-year-old male with PKMB of 5 years duration with deviation of urinary stream and histology showing acanthosis, hyperkeratosis with features of cellular atypia and abnormal mitosis suggestive of malignant transformation.