Purpose: We present the results of our series of six systematic sextant transrectal ultrasound guided biopsies in a prostate cancer detection program. Material and Methods: A total of 420 men referred to the outpatient clinic of our department to exclude prostate cancer, underwent examination wiith transrectal ultrasound and transrectal ultrasound guided systematic sextant biopsy. The reasons for referral vere, increased serum prostate specifıc antigen (PSA) level, finding of a palpable nodule on digital rectal examination or greater firmness of one prostatic lobe. Results: One hundred eighteen of 420 patients (28%), who underwent systematic sextant biopsies of the prostate, had prostatic carcinoma. The percentage of well differentiated prostate cancers decreased with increasing PSA level. Cancer was found more than twice as often in patients vith hypoechoic peripheral zones compared to those vith isoechoic ones. Twenty nine percent of all cancer detected was in an isoechoic prostate. Conclusion: Over all, 28% of patients who undenvent systematic sextant biopsies of the prostate had prostatic carcinoma. Although the transrectal ultrasound guided sextant biopsy technique is the gold standard for the detection of prostate cancer, the true false-negative rate is unknown.