Aim: To evaluate the best individualized prostate biopsy strategies for Chinese patients with suspected prostate cancer. Methods: The present study included 221 Chinese patients who underwent transrectal ultrasound guided prostate biopsies for the first time. All patients underwent the same 10-core biopsy protocol. In addition to the Hodge sextant technique, four more biopsies were obtained from the base and middle regions of bilateral peripheral zones.The differences between 10-core and sextant strategies in cancer detection among patients with different prostate specific anitgen (PSA) levels were evaluated. The relationship between PSA level, number of positive biopsy cores and organ-confined cancer rate in prostate cancer patients was also analyzed. Results: The overall prostate cancer detection rate was 40.7% in the 221 patients. The 10-core strategy increased cancer detection by 6.67% (6/90) in our patients (P 50 ng/mL (P 10 years and the sextant strategy should be applied in those with life expectancy < 10 years.