Prostate cancer (PCa) incidence is similar between Māori and non-Māori in New Zealand (NZ) but PCa survival is significantly lower among Māori. This study sought to identify the possible causes for inequitable PCa outcomes among Māori by examining any differences in the assessment, management, and treatment outcomes of Māori and non-Māori with PCa in NZ. 13983 men (1155 Māori and 12828 non-Māori) with PCa diagnosed between 1 January 2016 and 30 June 2022 were recruited from the New Zealand Prostate Cancer Outcome Registry, a national registry for collating PCa care and outcomes data. Socioeconomic data were gathered from a Ministry of Health database via data linkage. Multivariate regression analyses were performed to assess between-group differences in PCa care and outcomes controlling for confounders. At disease presentation, Māori were more likely to receive transrectal ultrasound guided prostate biopsy but less likely to receive transperineal prostate biopsy and pre-biopsy MRI scan compared to non-Māori. For PCa management, Māori were more likely to receive active surveillance and watchful waiting, radiotherapy, and hormonal therapy and less likely to receive surgery than non-Māori. Ethnic disparity in PCa assessment and management between Māori and non-Māori persisted after adjusting for confounders (p<0.001 to 0.04). Despite Māori reporting lower scores on patient-reported outcome measures than non-Māori at baseline, both groups showed a similar decline in scores 12 months post-treatment. Ethnic disparities in PCa care pathways could be an important factor in differences in PCa survival between Māori and non-Māori in NZ. Further studies are warranted to examine factors that may contribute to these differences.