Prostate specific antigen (PSA) is widely used as the first line test for the diagnosis of prostate cancer in asymptomatic men. The role of transrectal ultrasound is now predominantly accepted as a means of accurate biopsy of the prostate, but there is confusion about the best biopsy protocols for the diagnosis of prostate cancer. Optimum diagnosis of prostate cancer is obtained using a combination of digital palpation of the prostate, serum PSA measurements and transrectal sonography. The role of colour Doppler imaging in the diagnosis of prostate cancer is still under assessment.