Prostate cancer (PCa) is the most prevalent urological malignancy, exhibiting the highest incidence and the second-highest mortality among all male cancers. The incidence of PCa in men in China is consistently rising. Studies have shown that elemental exposure levels are associated with the occurrence of PCa. However, epidemiological data are limited, and more researches on different regions and races are needed. To clarify the relationship between the occurrence of PCa and serum levels of 19 trace elements. Serum samples from 79 PCa patients and 74 male healthy controls were obtained, and the levels of 19 trace elements were measured using inductively coupled plasma mass spectrometry (ICP-MS). Baseline matching of key demographic characteristics was performed between the two groups. The relationship between serum trace elements levels and PCa, prostate-specific antigen (PSA), and PCa staging were evaluated using the Mann-Whitney U test, logistic regression, and Spearman's correlation analysis. Statistical analysis of the test results revealed that the low levels of Cu, Zn, and Se in serum may be associated with the development of PCa. Moreover, the changes in the interrelationship of trace elements may play a role in the development of PCa.© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.