A review of the literature was performed about prostate biopsy. The prostate biopsy technique has changed significantly since the original sextant biopsy protocol. Numerous types of local anesthesia are now available, but periprostatic nerve block with or without intrarectal lidocain has proved to be the most effective method during TRUS biopsy. The optimal biopsy protocol should include six standard sextant biopsies, with at least 4 additional biopsies (10-12 cores) taken more laterally to the base and medially to the apex. Repeat biopsies should be based on more extended or saturation biopsies and should include the transition zone. For increasing accuracy of prostatic biopsy color and power Doppler imaging, contrast enhancement and magnetic resonance imaging now can be successfully performed, but their routine use is still controversial.