Objective To evaluate the feasibility of prostate biopsy under direct vision.Methods 56 patients recieved transrectal prostate biopsy under direct vision with a modified prone position.We used dilator and anal mirror suture device(parts of the PPH kit)to help revealing the prostate. Results Transrectal prostate biopsy under direct vision could achieve a very good view of prostate and made puncture easier by controlling the depth and direction.The puncture located well. The patient′s position was comfortable.The procedure were well tolerated in all patients.No serious complications occurred. Conclusions Transrectal prostate biopsy under direct vision with a modified prone position is simple and accurate.It might be generalized in the future.