Objective To analyze the distribution of prostate diseases in the elderly in Beijing, and explore the clinical value of ultrasound in the detection of prostate diseases Methods Prostatic diseases were screened by transrectal ultrasonography by PHLIIPS iU22. The distribution of prostate diseases was compared between the elderly and the middle-aged. Results Benign prostatic hyperplasia, prostatic stone, prostate cyst and prostatitis accounted for 70.7%, 31.1%, 14.2% and 1.5% in elderly group, respectively, and the corresponding data were 33.7%, 13.0%, 4.5% and 9.1% in middle-aged group, respectively. They showed a statistical significance between the groups (P＜0.05). Benign prostatic hyperplasia, prostatic stone and prostatitis were associated with age (P＜0.05). The incidence of benign prostatic hyperplasia and prostatic stone increased sharply with increasing age by Spearman correlative analysis (P＜0.05), and the prostatitis decreased with ageing (P＜0.05). Conclusions Benign prostatic hyperplasia and prostatic stone were the very common prostate diseases in the elderly, and their incidence grows with the age. It has great clinical value to use transrectal ultrasonography in the detection of prostate diseases.