In this study we report the first case of invasive prostatic aspergillosis (IPRA) in a heart recipient with post-transplantation antibody deficiency, and review the other 11 cases described in the medical literature. Seven patients were immunocompromised and 6 had dissemination to other sites. Examination of the prostate usually revealed enlargement, with or without nodular lesions. Transrectal ultrasonography or computed tomography scan can provide the diagnosis, although this should be confirmed with biopsy and culture of the lesion. Urine culture can be negative and treatment should include long-term systemic anti-fungal therapy and, in most cases, prostatectomy.