Aim of this investigation was to determine whether the evaluation of a new dynamic finding on conventional greyscale transrectal ultrasonography (TRUS), which we named as high-consistency area (HCA), is useful in detection of prostate cancer (PCa). Fifty-one consecutive patients were prospectively enrolled in this study. When TRUS-guided prostate biopsy was performed, HCA that was difficult to transform, due to transrectal compression using sonographic probe, was evaluated. HCA-targeting biopsy, digital rectal examination (DRE)-targeting biopsy and systematic 12-core biopsy were performed. All biopsy cores were diagnosed histopathologically. As the results, twenty-three PCas were detected in 51 patients. The sensitivity and specificity of HCA-targeting biopsy for correct diagnosis were 60.9% and 78.6%, respectively. The sensitivity and specificity for DRE-targeting biopsy were 47.8% and 78.6%, respectively. In conclusion, HCA-targeting biopsy of this study was superior to DRE-targeting biopsy with regard to detection of PCa. Before prostate biopsy, patients should be evaluated for DRE and HCA, and DRE and HCA-targeting biopsy should be performed.