Prostate biopsy is currently the gold standard in the diagnosis of carcinoma of the prostate. An estimated one million prostate biopsies are performed every year in Europe. Worldwide the most frequent form is the transrectal prostate biopsy using preoperative fluoroquinolone prophylaxis. In recent years an increasing rate of infectious complications after prostate biopsy has been observed. The main causative factor is fecal fluoroquinolone-resistant bacteria. This review aims to present the current evidence regarding infectious complications after prostate biopsy and strategies to reduce symptomatic infections and urosepsis.