Aim: the aim of this research to examine the influence of TRUS-guided biopsy samples from specified lesions in diffusion-weighted MRI on the detection rate of prostate cancer (MRI). Patients and Methods: This study cross sectional analytical study with follow up the results of biopsy was conducted on 25 patients with elevated PSA from 2.5 to 20 ng/ml undergone diffusion weighted MRI before TRUS guided biopsy. Patients were referred to the diagnostic radiology department from the outpatient clinic of urology department at Beni-Suef University Hospital from September 2018 to December 2020.The study explained to all participants and written informed consent taken from them before starting the  study and the approval of ethical committee of Beni-Suef was taken. Results: There were 72% of the studied patients had benign prostatic lesions and 28% had malignant lesions. There was a statistically significant higher level of PSA among patients with restricted MRI diffusion than who had normal MRI diffusion (P-value=0.030). The sensitivity of MRI diffusion in detection of malignant prostate masses was 71.4% its specificity was 94.4% %, the PPV was 83.3% and the NPV was 89.5%. Conclusion: In conclusion, transrectal ultrasonography (TRUS) guided biopsy samples from pre-determined lesions in diffusion-weighted MRI (MRI) resulted in an increase in the detection rate of prostate cancer while lowering the excessive biopsy rate.