Objective To evaluate the prevalence of prostate biopsy complications and identify its risk factors.Methods Clinical data of 1959 patients underwent prostate biopsy between Jan.2002 and Dec.2011 were retrospectively analyzed.These patients were divided into three groups according to different prophylactic antibiotics (Group A:quinolone+metronidazole; Group B:third generation cephalosporin+metronidazole; Group C:third generation cephalosporin+ beta lactamases).Baseline data and complications within 1 week following prostate biopsy were collected.The Logistic regression analysis were used for data analysis.Results Between 2002 and 2011,the rates of voiding and bleeding related complications of prostate biopsy were 80％ and15％,but the fever rates were 4.5％-13.5％.After prostate biopsy,the fever rate of group C was lower compared with group B and A (0.9％ vs.5.1％ vs.12.0％,P＜0.05),the fever rate of diabetic was higher than that without diabetes (10.9％ vs.7.2％,P＜0.05),the fever rate of patient with prostatitis was higher than that without prostatitis (10.1％ vs.6.9％,P).The fever after prostate biopsy was associated with diabetes,prostatitis and different antibiotics (OR =1.679,1.495,0.746; all P＜0.05),but was not related to prostate size,age,biopsy cores,anesthesia and pathology results (P ＞ 0.05).Conclusions Preoperative management of diabetes mellitus and prostatitis,and short-term application of antibiotics according to local bacterial resistance surveillance results can decrease the incidence of fever after prostate biopsy.