This study is a decade review of requests pattern for Prostate Specific Antigen (PSA), in a Nigerian tertiary health care. All plasma samples for PSA from January 2002-December 2011 were analysed weekly by immunoradiometric assay method. Biodata from request form were collated and analyzed. A total of 15079 requests were received for the period under review. There was a consistent and progressive yearly increase of request from inception to the last year of review but a sudden drop in 2010 only. Smoked or barbecued food, consumption of local herb and alcohol in order of importance, respectively, appears to be prominent factor in patient requested for PSA. There was an increasing trend in the proportion of requests with values outside the reference range over the years in review. This is consistent with previous report of increasing incidence of prostate cancer in Nigeria. Certain indigenous and tradition modifiable lifestyle especially, alcoholic, positive history of native herbs and smoked food consumption may play an important role in addition to underlying genetics and other previously implicated risk factor of prostate cancer in Nigeria.