OBJECTIVE: To evaluate the clinical value of the four regions 12-core systemic prostate biopsy. METHODS: Ninety-one patients suspected of prostate cancer received four regions 12-core systemic prostate biopsy, and the detection rate and complications were compared with those of the sextant method. RESULTS: More positive results were obtained in detecting prostate cancer with the four regions 12-core method, and the complications were similar to those of the sextant biopsy. CONCLUSION: The four regions 12-core biopsy was suggested for patients suspected of prostate cancer with enlarged prostate gland above 40 ml.