A new method of transrectal biopsy of the prostate using an Iowa trumpet is introduced. This method allows the urologist to biopsy what he or she palpates during a standard digital rectal examination. The methodology of using this biopsy guide is explained. Among 66 patients with a palpable prostatic abnormality 31 cancers were diagnosed with this new method, while only 15 cancers could be diagnosed with standard ultrasound guided biopsy techniques. However, of these 31 cancers 8 would have been missed without the aid of ultrasound. No unusual complications were noted with this new biopsy method.