A prostate PI-RADS score of 4 is a recommendation for a prostate puncture biopsy based on multiple imaging tests suggesting a high likelihood of prostate cancer. PI-RADS score refers to the Prostate Imaging Reporting and Data System, which evaluates the risk of malignancy of prostate lesions based on the T2WI sequence of MRI, diffusion-weighted imaging sequence, and dynamic-enhanced magnetic resonance imaging (DEMRI) sequence, and so on, and it is divided into 1~5. Most of the scores below 3 are benign, and the greater part of the scores above 3 are malignant. Therefore, a PI-RADS score of 4 means that there is a high probability of prostate cancer, and a prostate puncture biopsy is needed to further clarify whether there is malignant lesion of the prostate gland, and if there is a malignant tumor, radical surgery, radiotherapy and other treatments are needed. It is recommended that the patient should consult the doctor in time and follow the doctor’s instructions for further examination and treatment.