Transrectal ultrasound (US) is the most commonly used imaging tool in the evaluation of the prostate. This article provides a synopsis of the normal and abnormal transrectal US findings of the prostate. The changes in normal transrectal US findings with aging are described, with simplified illustrations. The transrectal US findings of each disease of the prostate are also described. The clues, radiologic or combined with serology, which are helpful for differentiating between common prostatic diseases are also discussed. The seminal tracts are similarly discussed, with an emphasis on male infertility.