Abstract We describe a simple, practical technique for producing elastography images of the prostate. Our standard technique for the detection of prostatic cancer is ultrasound guided systematic biopsy of the prostate, with extra targeted biopsies of any abnormal areas detected by grey-scale ultrasound. The aim of this study to determine whether adding elastography imaging with targeted biopsies of abnormal areas detects more cancers. The results of elastography imaging were evaluated against grey-scale images and biopsy data in 100 patients. Elastography detected an additional 5 cancers in the 100 patients and detected an extra 3 patients with cancer at the expense of 8 extra biopsies. This represents a significant improvement in the detection rate of prostatic cancer. Cochlin, D. Ll. et al. (2002). Clinical Radiology 57, 1014–1020.