Abstract: Objective To analyze the clinical and pathological features of prostate cancer patients with negative transrectal ultrasonography （TRUS） findings. Methods Seventy-three prostate cancer patients diagnosed by TRUS-guided transperineal biopsy were enrolled in this study from January 2015 to January 2017. All the patients were divided into negative TRUS group（n=31） and positive TRUS group（n=42） according to TRUS findings. The clinical and pathological features of the two groups were analyzed and compared. Results The serum prostatic spelific antigen（PSA） level of TRUS positive group was （71.27±9.71） ng／ml， higher than （41.62±6.43） ng／ml of TRUS negative group （P<0.05）. However， there were no significant differences in terms of age， Gleason score in primary and secondary areas， microvessel density， length of tumor tissue length （the most typical needle）， clinical staging， number of no obvious symptoms， number of vascular lymphangiosis， number of nerve invasion and number of infiltrating surrounding tissues between two groups （P＞0.05）. Conclusion If the patients with abnormal serum PSA level or （and） clinical symptoms but without suspicious TRUS findings， TRUS-guided prostate sysmatic biopsy is still necessary for them in order to avoid delaying the clinical treatment.