We report our experience-based approach in transperineal ultrasound guided biopsy to detect early prostate cancer. We selected patients on the basis of clinical characteristics. We tried to determine correct number and sites of biopsy to reduce patient discomfort and complications without loosing sensibility. Routine TZ biopsy increases detection rate of prostate cancer in T1 patients. Lateral peripheral biopsy resulted in a loss of sensibility of 5% and thus we considered it useless. Literature reported gain of sensibility with lateral peripheral biopsy referred to transrectal technique. Needle angle of incidence is different and therefore the area biopsied differs. Thus, results are not comparable.