Elastography was described in 1991 by Ophir. Palpation of tissue is the oldest physical examination as palpation of the breast or prostate (DRE). Hard palpable tissues are suspicious for cancer and this is basic principle of the real-time elastography (RTE). It is a ultrasound technique and is able to visualise tissue elasticity. Despite of low spesificity of PSA and low sensitivity of systematic biopsy, they are gold standarts for PCa diagnosis. Nowadays, PCa can detected with high sensitivity by multiparametric MRI or contrast-enhanced TRUS. On the other hand, real time elastography can be prefered because of chep and non invasive. Strainelastography (red; softtissue, blue; hard tissue) and shear-waveelastography (35-37 kPA; kilopascal) were described. Prostatitis, fibrozis, BPH may be associated with increased tissue stiffness can be responsible for low positive predictive values as 39%. Some authors reported best performance of the SWE elastography as sensitivity (63%), specificity (91%), PPV (69.4%) and NPV (91%). RTE targeted biopsy can be recommended for detection of PCa but nowadays it is not standard. RTE may be particularly suitable for detection of clinically significant cancers. RTE may misss carcinomas with a primary Gleason pattern of 3 (falsenegative). In the future, elastography techniques will developed by moresensitive probes and it can be helpful for detection of PCa additional to DRE.