Objective To explore the diagnostic value of prostate biopsy based on rectal ultrasound in pa-tients with prostate cancer.Methods A total of 100 patients with suspected prostate cancer admitted to the De-partment of Ultrasound Medicine,Weihai Municipal Hospital from June 2020 to June 2023 were randomly se-lected as the study objects.All patients underment surgical pathology examination(gold standard).Preoperative prostate biopsy based on rectal ultrasound was performed to analyze its clinical diagnostic effect and safety.The receiver operating characteristic(ROC)curve was drawn to analyze the clinical diagnostic performance of pros-tate biopsy guided by transrectal ultrasound.Results 53 cases were confirmed by surgical pathology examina-tion in 100 patients with suspected prostate cancer,and 49 cases were confirmed by transrectal ultrasound-guided prostate biopsy.The kappa value was 0.751.The ROC curve results showed that the diagnostic area un-der curve value of prostate biopsy based on rectal ultrasound in patients with prostate cancer was 0.878,the di-agnostic sensitivity was 88.68%,and the diagnostic specificity was 95.74%.Conclusion Transrectal ultrasound-guided prostate biopsy can achieve a high diagnostic accuracy rate in patients with prostate cancer,help patients to be diagnosed early,reduce the number of pathological examinations,and can guide clinical di-agnosis and treatment.