Introduction: Prostate lesions are of common occurrence in men, particularly in old age. Digital Rectal Examination (DRE) has remained a primary screening diagnostic aid for these lesions coupled with ultrasound and biopsies. The discovery of Prostate-Specific Antigen (PSA) has led to novel pathways in the detection of these lesions, particularly for malignant types. Hence this study was undertaken to correlate histopathological findings with PSA levels in a health care facility in Ranchi. Material and Methods: The study was conducted in Rajendra Institute of Medical Sciences, Ranchi. Serum PSA values and histopathological evaluation of prostatic biopsies were conducted and correlated. Raised serum PSA levels were divided into three groups based on set values. Results: A definite predilection for older ages was noted, with the 5 th and 6 th decades having the highest numbers of prostatic lesions. The sensitivity of PSA in the detection of carcinoma prostate cases was calculated to be 81.8%. The sensitivity of DRE was found to be 45.45% in the detection of cases of carcinoma of the prostate. Conclusion: The current study demonstrated serum PSA levels to be a reliable front-line technique in assessing an individual's risk for prostatic lesions.