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African-Americans (AA) are at risk for benign ethnic neutropenia (BEN), which has been implicated as a potential source of disparity in cancer outcomes among AAs. Since AAs with prostate cancer (PCa) are more likely to have aggressive pathological features, this investigation sought to determine if absolute neutrophil count (ANC) is associated with adverse pathologic findings at radical prostatectomy (RP) within a cohort of AA men.A single-institution, retrospective review was conducted of all AA patients undergoing RP who had a pre-operative CBC with differential and known RP pathology. Neutropenia was defined as ANC ≤1.5 × 109/L (1.5). Clinical and pathologic variables were characterized for the study cohort, and Cox regression and Kaplan–Meier analyses performed to evaluate the association between ANC and adverse pathology.A total of 336 patients were included, and 18 patients (5.4%) had ANC ≤1.5. Mean age was 59.8 ± 7.5 years; mean follow-up time 47.4 ± 43.3 months. Neutropenic patients had significantly higher clinical stages and pathologic Gleason scores (P < 0.05). On multivariable analysis, ANC ≤1.5 was significantly predictive of high tumor grade (HR 1.22, CI 1.01–1.48).Neutropenia in AAs predicts high tumor grade at prostatectomy. Further studies are necessary to further characterize the importance of these findings with regard to the pathogenesis of PCa, particularly as it relates to the AA population.