Objective. To determine the compliance rate for treatment recommendations consistent with expectant management of inner-city men with prostate cancer. Methods. Twenty-seven out of 560 men who underwent biopsy of the prostate were found to harbor cancer and opted for expectant management. Clinic and hospital records were reviewed for adherence to follow-up schema. Results. Of the 27 men on expectant management, 22 men (82%) adhered to strict follow-up schema. At 6-month follow-up, there were no significant changes in clinicopathologic features (e.g., prostate specific antigen (PSA), Gleason score, and stage). With a median follow-up of 12 months, only 2 men demonstrated a rise of more than 30% from baseline PSA (repeat biopsy demonstrated persistent low grade, low stage disease). Conclusions. Our findings imply that expectant management may be feasible in inner-city settings. Thus, in subsequent expectant management trials, inner-city men should be actively recruited.