The epidemiology of prostate cancer has radically changed during the last decades, with a tendency to an increasing number of diagnoses and a concomitant reduction of mortality. This is due to both the introduction and the diffusion of PSA as a screening test, and the improvement of imaging and the standardization of prostate biopsy. Currently, TRUS represents the gold standard radiological exam for prostate imaging because of the best costs/benefits ratio. Nevertheless, it has shown to be not highly accurate (50–60%), with a low positive predictive value (about 6%) in the diagnosis of prostate cancer and with a low reliability in local staging: Thus, the role of TRUS in the evaluation of prostate in cases of a suspect prostate cancer is still under discussion.