Objective To investigate the application value of differentiating benign and malignant prostate solid nodules using contrast-enhanced trans-rectal ultrasonography by analyzing the enhancement modes. Methods The perfusion characteristics of contrast-enhanced trans-rectal ultrasonography (CETRUS) of total 55 solid nodules of 43 patients with prostate disease confirmed with puncturing or pathology, were analyzed from five aspects such as enhanced time, the degree of enhancement, regression time, enhanced homogeneity and the enhanced boundary, the differences of perfusion characteristics between benign and malignant nodules were compared relatively. Results With the pathological results as the gold standard, 55 prostate solid nodules were divided into malignant group including 33 nodules and benign group 22 nodules, there were statistical significances in benign and malignant nodules of rapid enhancement, rapid decrease, heterogeneous enhancement and well-defined boundary (P＜0.05); there was no significance in hyper-enhancement between the two group (P>0.05). Conclusion CETRUS can observe real-time dynamic perfusion of prostate nodules, analyzing the characteristics of enhancement patterns can help to improve the ability of ultrasonography in the diagnosis of prostate solid nodules.