Objectives: To set the efficacy of transrectal Power Color Doppler Ultrasonography (PCDU), in the prediction of prostate cancer. Patients & Methods : Sixty patient with possible prostate cancer suspected from an abnormal digital rectal examination, DRE or elevated prostate surface antigen, PSA, underwent transrectal ultrasound with Power Color Doppler Ultrasound, PCDU using a 7 Mhz probe optimized to detect blood flow within the gland and along the capsular margin. Color flow was graded on a scale, from grade 0 to grade 2, as regards grade 1- 2 were considered positive and grade 0 negative. Results: Of the sixty patients who underwent histo-pathological confirmation, through trans-rectal core biopsies, 26 patients had a malignant prostate (43.3%), while 34 cases had benign histological findings (57%), 8 patients with BPH, 20 cases have chronic inflammation and 6 cases with focal atrophy. The sensitivity of PCDU was 92.3%, while the specificity was 64.7%, positive predictive value was 66.6%, and the negative predictive value was 91.6% for the diagnosis of prostate cancer. Conclusion: Focal hyper-vascularity on PCDU was associated with increased like hood of prostate cancer. This technique appears to increase the sensitivity and to help identify appropriate sites for biopsy.