This article examines one of the most common outpatient diagnostic procedures carried out in urology-the transrectal ultrasound (TRUS) and prostatic biopsy. Following an exploration of the aetiology, anatomy and physiology of prostate disease, an explanation is given regarding the clinical investigations that inform the decision-making process and precipitate the procedure. Technical, clinical and ethical issues will be explored before a thorough examination of the TRUS and biopsy procedure and the crucial role of the registered nurse and healthcare assistant. References are made to the elements of nursing care required throughout this most invasive of procedures. These include counselling, discharge information and the maintenance of patient dignity in relation to gender-sensitive care.