The detection of an elevated value of prostate-specific antigen does not require an immediate biopsy. The antigen level should be checked again after several weeks in the same laboratory and by the same method, using the same laboratory kit and standard conditions. Standard conditions mean absence of uroinfection, no ejaculation before sampling, no urological manipulations, such as digital rectal examination, prostate massage, catheterization and cystoscopy. The standard for taking a prostate biopsy requires that it be done under ultrasound control. Although transrectal (through the rectum) access is used in most cases, some urologists prefer the perineal route (the area between the anus and the genitals). There were no distinct differences between the two approaches in terms of the frequency of detected carcinomas. Perineal access under transrectal ultrasound guidance is a good alternative in some special cases, for example after rectal amputation. Complications during the procedure could be minimized if a comprehensive history is taken from the patient about the presence of other accompanying diseases, use of anticoagulants and antiplatelets, presence of implants, allergies to food and drugs. Patients should be specifically questioned in detail about the presence of manifestations of acute prostatitis, which is a contraindication for biopsy. Enlarged prostate, already controlled uroinfection, previous biopsies, presence of malignant disease, pain and hematuria during and after prostate biopsy do not increase the risk of complications. It has been shown that elderly patients and also those with preserved foreskin are more susceptible to bacteriuria after the procedure. Indirect coagulant intake should be temporarily stopped a few days before the procedure, and the INR should be below 1.3. Other anticoagulant, antiplatelet and antithrombotic medications, such as aspirin, non-steroidal anti-inflammatory drugs, clopidogrel should be stopped one week before the biopsy. The use of low-dose aspirin is no longer considered an absolute contraindication. Large hemorrhoidal nodes and the presence of fissures or proctitis increase the risk of postoperative bleeding, while hypoglycemia increases the risk of autonomic reactions. That is why patients, especially diabetics, are allowed to have breakfast before the procedure. Bowel preparation includes giving a purgative the day before and an enema performed on the day of the biopsy, immediately before it. Freeing the ampulla of the rectum from existing faecal masses allows a good view and a smooth procedure. Although some dispute the necessity of the enema, most authors are of the opinion that the enema reduces the level of bacteremia and is preferable. Prophylactic administration of oral or intravenous antibiotics is considered mandatory for prostate biopsy. The optimal antibiotic dose and duration of treatment vary considerably.Medicines of choice are antibiotics from the quinolone group, with ciprofloxacin having a good effect. Therapy with it starts the day before and continues for 1 week after the procedure. Additionally, metronidazole can be included against anaerobic infection.