Background: Low-flow priapism is a urological emergency that can cause permanent erectile dysfunction if not treated quickly. Blood diseases such as chronic myeloid leukemia (CML) can cause priapism, but it is very rare for priapism to be the first sign of CML, especially in young adults. Early diagnosis and treatment of the cause are essential to save erectile function and control the disease. Objective: To describe the symptoms, treatment, and outcomes of five patients who presented with low-flow priapism as the first sign of CML, and to show the importance of using tyrosine kinase inhibitors (TKIs) in Sub-Saharan Africa. Methods: This observational study was carried out between 2022 and 2025 in three tertiary hospitals in Sub-Saharan Africa. Five men aged 18–35 years came with painful, prolonged erections not related to sexual activity. Initial surgery (caverno-spongious shunts) did not fully solve the problem. Blood tests confirmed CML, and patients were given cytoreductive drugs followed by TKIs (imatinib). Results: All five patients had very high white blood cell counts (500–644 G/L) and enlarged spleens. After starting TKI therapy, full detumescence occurred within 3–5 days, and erectile function was preserved. One patient who had paraplegia recovered fully within two months. No recurrence of priapism was noted during follow-up. Conclusion: Low-flow priapism can rarely be the first symptom of CML in young adults. Surgery alone may not be enough; early treatment with TKIs is key for rapid recovery, preserving erectile function, and controlling the disease. This series highlights the need for quick diagnosis and combined treatment, especially in low-resource settings.