ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography.