Human Brucella infection can cause lesions in many organs of the body, mainly manifesting as long-term fever, fatigue, arthritis, neuralgia, hepatosplenomegaly, etc., and its clinical manifestations are diverse and non-specific, which makes brucellosis easily misdiagnosed. Brucella infection of the prostate can lead to elevated serum prostate-specific antigen (PSA), which is easily misdiagnosed as prostate cancer bone metastasis when accompanied by bone destruction. We herein report a case of prostatitis with spondylitis caused by brucellosis, which was misdiagnosed as prostate cancer bone metastasis before operation. Prostate biopsy was planned. The patient had recurrent fever and low back pain before operation, and the use of conventional broad-spectrum antibiotics was ineffective. Through multi-disciplinary team discussion, the specific relevant examinations were performed. The epidemiological history was inquired in detail again, and the diagnosis was finally corrected and confirmed. This case highlights the importance of recognition of atypical symptoms caused by Brucella infection. In addition, we review the relevant literature and summarize the characteristics of this case, with an aim to deepen the understanding and diagnosis of brucellosis, reduce misdiagnosis, and facilitate standardized treatment and management.