We report the occurrence of an epidural abscess following TRUS-guided prostate biopsies, which highlights the fact that severe complications may occur with this technique in spite of antibiotic prophylaxis. Ciprofloxacin-resistant Escherichia coli is a frequent cause of fever following TRUS-guided prostate biopsies as was the case in our patient. Early suspicion of the presence of ciprofloxacin-resistant Escherichia coli may help avoid serious complications in these patients.