Aim: The comparison of diagnostic accuracy for prostate cancer detection between elastography plus MRI image based TRUS biopsy versus extended core biopsy. Methods: This Comparative study was carried out in the Department of Radio Diagnosis, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India for the period of 6 months. 50 Patients with age group of 35 to 75 years, with Serum PSA greater than 4.0 ng/dl were included in this study. All patient underwent TRUS biopsy based on the MRI and elastography images, followed by TRUS guided extended core biopsy (13 cores) done by radiologist randomly. The rate of prostate cancer detection was compared between the two types of biopsies. Group A consisted of cores from MRI plus Elastographyguided TRUS biopsy and Group B were cores from extended core biopsy.