High total prostate-specific antigen indicates that prostate cancer may be present. In the elderly, the combination of ultrasound and prostate magnetic resonance should be used to find out whether there is prostate cancer or whether there is a space-occupying lesion in the prostate. Once there is prostatic space-occupying lesion and the total prostate antigen is obviously elevated, the possibility of prostate cancer is highly considered, and further puncture biopsy of the prostate mass is needed to clarify the nature of the pathology. If it is indeed prostate cancer, it is necessary to further clarify the pathological stage and decide whether to treat it surgically or with simultaneous radiotherapy or chemotherapy alone. In conclusion, high total prostate-specific antigen mainly indicates that the prostate gland may be inflammatory or tumor, and the specific pathological nature needs to be clarified by puncture biopsy of the prostate mass.