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Background: Diseases are primarily affecting the prostate gland ranged from inflammation to hyperplasia to malignant tumors. Carcinoma of the prostate is most common nonskin cancer in the west and the second leading cause of cancer death among men. Gleason's microscopic grading is a paramount feature and with prostate-specific antigen (PSA) are important for diagnosis, management, and prognosis of carcinoma. Objectives: The objectives were to evaluate the patterns of prevalence of prostatic lesions among the insured persons of the model hospital and to correlate histology with respect to serum PSA levels. Materials and Methods: Clinicopathological study of prostatic biopsies was conducted over a period of 1-year with emphasis on Gleason's grading and correlation of the same with PSA levels. Results: Individuals with PSA >10 had 18 times more chance of being biopsy positive in comparison to PSA <10. Conclusion: Confirmation for malignancy/screening in high-risk people is needed when PSA value is more than 4 since sensitivity is 100%, rather than PSA more than 10.