Primary carcinoid tumor of the prostate is a rare tumor derived from the amine precursor uptake and decarboxylation cells of the prostate. We report a case of a 71-year-old man who presented with progressive anemia due to bone marrow metastases from primary carcinoid tumor of the prostate. No other metastasis was found clinically. This pattern of metastasis is very unusual and illustrates that carcinoid tumor of the prostate may metastasize distantly without locoregional lymph node involvement. This unique case highlights the need for a multidisciplinary approach to the evaluation of a metastatic carcinoid tumor of an unknown primary and that it should include the prostate.