Objective To investigate the value of 11C-choline PET-CT imaging in the diagnosis of benign and malignant prostate lesions with high PSA.Methods A retrospective analysis of 11C-choline PET-CT imaging results of 43 prostate lesions cases with high PSA, including 21 cases of benign prostatic hyperplasia, 22 cases of prostate cancer, all cases were diagnosed by histopathology , data was accessed 5min after injection of 11C-choline , if suspected of metastasis, whole body 11C-choline PET-CT imaging was done.Standardized uptake value ( SUV) of prostatic hyperplasia and prostate cancer were calculated and analysed.Results More uniform uptake of the imaging agent showed in benign prostatic hyperplasia, uptake in the mild metabolic or nodular prostate symmetry slightly increased, the average SUV value 1.70 ± 1.09;focal asymmetry abnormal imaging agent uptake or diffuse abnormal uptake of the imaging agent of prostate cancer manifested in 11C-choline PET/CT imaging for prostate heterogeneity were increased, the average SUV values 3.29 ±1.55;The two groups had statistically significant.Four pelvic and retroperitone-al lymph node metastasis cases ,nine cases of bone metastasis and three cases of lung metastases was found in 11C-choline PET/CT imaging.Conclusions 11C-choline PET-CT imaging is not only a better differ-ential noninvasive imaging diagnosis method of benign and malignant prostate lesions with high PSA, but al-so has contribution to accurate preoperative staging of prostate cancer.