INTRODUCTION: Severe acute respiratory syndrome coronavirus (SARS-CoV-2) has affected over two hundred million people. Numerous studies have evaluated its impact on cancer patients in regards to COVID-19 severity and outcome. However, there is limited data available to understand SARS-CoV-2 potential impact on patients with prostate cancer and other types of genitourinary (GU) malignancies. METHODS: We performed a retrospective cohort analysis of hospitalized patients with SARS-CoV-2 and a GU malignancy from 2 academic hospitals (LAC+USC Hospital and UCLA Health) in Los Angeles, CA between March 2020-February 2021. Demographic information, medical history, cancer characteristics, treatment history, and clinical outcomes of SARS-CoV-2 were reviewed. Associations between relevant variables and COVID-19 outcomes were evaluated for significance by chi-square test with p=0.05. RESULTS: A total of 141 hospitalized patients with GU malignancies were analyzed. Median age was 74 (range 29-100). The most common ethnicities represented were Hispanic/Latinx (38.2%), White/Caucasian (34.8%), and Black/African American (11.3%). The most common GU cancers included prostate (63.8%), renal (15.6%), and bladder (15.6%). Eighteen patients (12.8%) had a history of a second non-GU malignancy while 8 patients (5.67%) had a history of a second GU malignancy. The majority (59.6%) of the patients had localized disease. Among all 141 patients, 31 (22.0%) patients required ICU level care; 17 required vasopressors, 16 were intubated, and 6 experienced renal failure. There were a total of 9 patients with a thromboembolic event (Pulmonary Embolism (PE)/Deep Vein Thrombosis (DVT) or Cerebrovascular Accident (CVA)). Having active cancer status showed a trend (p=0.07) towards association with severe disease requiring ICU care; there were no other significant associations found. There were 19 deaths in total (13.4%); among these, the median age was 80 (range 55-99), with nearly 2/3 (64.1%) having prostate cancer and over 3/4 (78.9%) having either a history of diabetes or hypertension. Among 5 patients treated with immune checkpoint inhibitors, 1 died from complications related to COVID-19 while the other 4 did not. CONCLUSION: Patients with GU malignancies are at risk for poor outcomes due to COVID-19 infection, especially those who are older and actively being treated for cancer. Further research is needed to understand the interplay between the virus and GU malignancies.