High resolution micro-ultrasound (micro-u/s) is a novel technology that permits visualization of lesions suspicious for prostate cancer. The resolution of 70 μ, that of a prostatic duct, means that alterations in ductal anatomy and cellular density are readily apparent. Initial experience in multiple centers comparing it to mpMRI suggests that the sensitivity for clinically significant prostate cancer is comparable or superior. Specificity is comparable or mildly reduced. Micro-u/s is an inexpensive, accessible and convenient alternative to mpMRI for imaging and diagnosing prostate cancer.