Objective   To observe the value of reduced field-of-view diffusion-weighted MRI (rFOV DWI) for prostate cancer (PCa) detection in the TRUS-guided transperineal prostate biopsy.Methods    A total of 54 patients with suspected PCa underwent rFOV DWI before TRUS-guided prostate biopsy were prospectively enrolled in this study. All rFOV DWI data were carried out by two  independent radiologists using prostate imagingreporting and data system (PI-RADS) assessment category, and systemic 10-core biopsy (SB) combined with rFOV DWI targeted biopsy (rFOV DWI-TB) were taken. According to histopathology results, the performance of rFOV DWI was analysed. Additionally, the detection rate of PCa and the positive rate of punctures of SB, rFOV DWI-TB and SB combined with rFOV DWI-TB were compared.Results   Overall, 26 of the 54 patients (48．15%) had histologically confirmed PCa. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detecting PCa with rFOV DWI was 80．77%, 89．29%, 87．5% and 83．33%, respectively. The ROC curve analysis revealed the AUC was 0．916. Additionally, the sensitivity for detecting clinically significant PCa with rFOV DWI was 95%. The PCa detection rate of SB, rFOV DWI-TB, and combination of SB and rFOV DWI-TB was 37．04%, 42．59% and 48．15%, respectively. The detection rate for combination of SB and rFOV DWI-TB was significantly higher than that of SB only (P=0．031). Additionally, the detection rate for rFOV DWITB cores (78．33%) was significantly better than for SB cores (15．5%)(χ²=124．377，P=0．000).Conclusions   rFOV DWI may be useful for providing more information of PCa lesions in targeted prostate biopsy, and has potential value in clinically significant PCa detecting.