Prostate cancer is one of the most common malignant tumors in middle-aged and older men, and prostate puncture biopsy is the main clinical method to confirm the diagnosis of prostate cancer. Initially, blind puncture and rectal finger-guided puncture were used. Since the 1980s, transrectal ultrasound-guided prostate puncture biopsy has been widely used and is now an accepted safe and accurate method of puncture guidance. Depending on the route of puncture, prostate puncture biopsy can be divided into transrectal puncture and transperineal puncture, both of which have their advantages and disadvantages, and patients can choose with reference. The biopsy is performed with the patient in a lateral or thoracic knee position, and the needle is passed through the rectal wall to the prostate. In general, transrectal puncture is convenient, accurate, and can be done by one person without anesthesia. However, preoperative bowel preparation is required, and only the tip of the needle can be seen during the puncture, and it is not easy to see the needle as a whole. The target to be punctured needs to be overlapped on the ultrasound instrument screen and the puncture guide line to perform the puncture. Postoperative infectious complications are more frequent, and most scholars advocate prophylactic use of antimicrobials. Perineal puncture: less likely to be infected but more time consuming Trans-perineal puncture is performed under the guidance of an online array or biplane rectal probe without the need for a puncture frame. The trans-perineal route requires two people to perform the puncture and requires local anesthesia of the perineal skin. Because of the long needle path, repeated adjustments are often necessary due to deviation, making it relatively time consuming. However, because the acoustic beam is perpendicular to the puncture needle, the puncture target and the entire puncture needle (including the needle tip) can be displayed simultaneously during the puncture. Since the puncture route does not pass through the rectum, bowel preparation and prophylactic antibiotics are not required, and postoperative rectal bleeding does not occur and is less likely to cause infectious complications.