This ethnographic study explored the experience of treatment decision-making among urban Black men who were diagnosed with prostate cancer in San Diego, California. Specifically, this research was conducted to further understand the decision-making process among Black men and the barriers they face when making treatment decisions about prostate cancer. The study is important because prostate cancer disproportionately affects Black men in the United States, and yet they are underrepresented in research studies (Randolph, Coakley, & Shears, 2018). These inequities are poorly understood and need considerable analysis and exploration. Still unclear is the possible effect of historical trauma or negative healthcare experiences on these treatment decisions. Findings revealed that Black men diagnosed with prostate cancer need a trusting patient-provider relationship, accurate and complete treatment information, and enough time to make effective treatment decisions