Carcinoma of the prostate (PC) is the most common cancer in men. Ultrasound (US)-guided prostate biopsy with 10-12 cores is considered to be the gold standard in the diagnosis of PC, although a systematic biopsy may miss a considerable percentage of prostate cancer. Substantial efforts have been made to improve the detection rates with extensive prostate biopsy schemes. Today, the most promising tools to improve the detection rate are various imaging procedures. This review focuses on the current stautus of ultrasound imaging in the detection of PC, such as contrast-enhanced colour Doppler ultrasound and real-time elastography. With the use of these techniques, it is the intention not only to improve the detection rate but they could also serve beneficial for staging and in order to reduce the number of biopsy cores. However, further clinical trials will be needed to determine the value of these new US advances.