To morphometrically compare local atherosclerotic changes in cancerous prostate with those in noncancerous prostate specimens, as epidemiological studies report a positive association between the prevalence of general atherosclerosis and prostate cancer.The intima-to-media-ratio (IMR) of 538 prostate capsular tissue arteries was measured in 50 prostate cancer-positive and 29 prostate cancer-negative specimens (including 26 with benign prostatic hyperplasia and three with normal prostatic tissue).An IMR of >1 was significantly associated with prostate cancer and a greater risk of prostate cancer (odds ratio 2.28). The IMR was >1 in cancer-positive specimens about twice as often as in cancer-negative tissue.Local atherosclerosis (measured by the IMR) was more pronounced in prostate cancer-positive than in prostate cancer-negative specimens. The results support the view that men with local atherosclerotic lesions are at higher risk of prostate cancer.