Aim: The aim of our study was to analyze the value of prostate gland volume measurement by transrectal ultrasonography (TRUS) in prediction of severity of lower urinary tract symptoms (LUTS). Material and methods: One hundred and one patients undergoing TRUS guided core needle prostate biopsy for the investigation of prostate cancer were prospectively evaluated. All patients had filled in the international prostate symptom score (IPSS) scala, has been tested for PSA and prostate volume measurement was done by TRUS prior to biopsy. According to their biopsy results, patients were divided into two groups: negative and positive for malignancy. Results: There was a significant but low correlation of 0.37 between IPSS and prostate volume measurement by TRUS (p=0.001). Serum free prostate specific antigen (fPSA), total PSA (tPSA), ratio of fPSA to tPSA and PSA density did not show a statistically significant correlation with IPSS (p>0.05). No statistically significant difference in IPSS between the benign and malignant groups (p=0.681) was found. In the benign group, mean IPSS was 14.59 +/- 8.73, range: 0-35 while in the malignant group, mean IPSS was 15.33 +/- 9.22, range: 3-28. Conclusions: Prostate volume measurement by TRUS is a poor predictor for the determination of the severity of LUTS therefore IPSS should be primarily considered for the determination of the severity of LUTS. Also, according to this study conducted with patients who were at their first set of prostate biopsy, IPSS cannot be used as a predictor of malignancy. PSA values were not related to IPSS.