Prostate cancer is the third most common cancer diagnosed in men and one of the leading causes of cancer related death. In view of the increasing number of patients with prostate problems as the prostate cancer (PCa) and benign prostatic hyperplasia (BPH) among the Sudanese population, and due to difficulties in the trans-rectal ultra sound (TRUS) biopsy taken which is unpleasant for the patients, this book aimed to achieve the evaluation of Serum Prostatic acid Phosphatase (PAP), Total Prostatic Specific Antigen (TPSA) and Free Prostatic Specific Antigen (FPSA) as markers of prostate cancer in Sudanese patients. This study concluded that determination of FPSA/TPSA ratio improves differentiation of PCa from BPH when serum Total Prostatic Specific Antigen level of 4 to10 ng/ml. and recommends a cut-off value of 18% to be applied to Sudanese patients to decide whether to biopsy the prostate.