Background: Prostate cancer (PCa) contains a small population of cancer stem cells (CSCs) that promote tumor growth, maintenance, and progression. Therefore, CSC markers could provide a prognostic strategy for human malignancies. This study aimed to evaluate the expression patterns and clinical significance of stem cell marker aldehyde dehydrogenase 1A1 (ALDH1A1) in prostatic tissues. Methods: This is a retrospective study performed upon 60 cases designated as; 10 cases (16.7%) of benign prostatic hyperplasia (BPH), 6 cases (10%) of high-grade prostatic intraepithelial neoplasia (HGPIN) and 44 cases (73.3%) of prostatic adenocarcinoma (PCa) of different Gleason scores. Immunohistochemistry was applied on formalin-fixed, paraffin-embedded tissue blocks using ALDH1A1. Clinicopathological data were reviewed from patients' pathological reports and the relation between ALDH1A1 expression and clinicopathologic parameters was assessed. Results: Low expression of ALDH1A1 was seen in 10/10 (100%) of BPH cases, 5/6 (83.3%) of HGPIN and 12/44 (27.3%) of PCa, while high expression was in 1/6 case (16.7%) of HGPIN and 32/44 (72.2%) of PCa cases. There was a significant difference between the expression level of ALDH1A1 in PCa compared with HGPIN and BPH cases (P