Objective To explore the clinical effect of perineal color ultrasound combined with magnetic resonance imaging(MRI)in the diagnosis of prostate cancer.Methods A retrospective analysis was performed on 80 patients with prostate biopsy in our hospital from July 2020 to September 2022.According to different puncture methods,they were divided into transrectal prostate biopsy(TRPB)group(40 cases)and transperineal prostate biopsy(TPPB)group(40 cases).With pathological examination results as the gold standard,puncture time,puncture needle number,puncture positive needle number,pathological examination results,Gleason score and complication rate of the two methods were analyzed,and the diagnostic value of TRPB and TPPB in prostate cancer was also analyzed.Results There were no significant differences in the number of puncture needles,the number of puncture positive needles,the malignant rate of pathological examination and Gleason score between the two groups(P>0.05).The puncture time in TRPB group was longer than that in TPPB group(P<0.05).The incidence of postoperative fever and puncture point bleeding in TRPB group was higher than that in TPPB group,and the incidence of pain was lower than that in TPPB group,with statistical differences(P<0.05).There was no significant difference in the incidence of hematuria and lower urinary tract symptoms between the two groups(P>0.05).The accuracy of TPPB method in the diagnosis of prostate cancer was 92.5%higher than that of TRPB method(75.0%),with statistical difference(P<0.05).There was no significant difference in sensitivity and specificity between the two methods for diagnosis of prostate cancer(P>0.05).Conclusion The application of perineal color ultrasound combined with MRI precision prostate puncture has high application value in the diagnosis of prostate cancer,which can effectively reduce the risk of complications such as fever and puncture point bleeding,shorten the operation time,and have high safety,which is worthy of promotion and application.