Objective To evaluate serum TPSA and F/T ratio in the differential diagnosis of BPH and PCa. Methods Serum TPSA,FPSA and F/T ratio in 177 cases of BPH and 60 cases of PCa were assessed and evaluated both in patients within and outside the "gray zone". Results TPSA and F/T ratio were both significantly discriminating between benign and malignant diseases (0.010.05) whereas F/T ratio could ( P 0.05). Conclusions Serum TPSA is a prostate carcinoma marker,F/T ratio being an adjuvant marker of TPSA of importance on the differential diagnosis in patients within the "gray zone".