Objective：To compare the analgesic efficiency?and?safety between local apical periprostate?infiltration anesthesia and combined periprostatic nerve block (PPNB) in transperineal prostate biopsy(TPPB). Methods：80 patients who underwent transperineal prostate biopsy in the Ultrasonic Diagnosis Department of Affiliated Hospital of North Sichuan Medical College were enrolled in during April 2017 to October 2012. After transrectal ultrasound examination, assessing the prostatic diameter, prostate volume , transition zone, capsular and seminal vesicle characteristics, blood flow and the suspicious lesions etc. Two different?anesthesia?styles were randomly selected between left and right lobe prostate . The first group received local?Lidocaine anesthesia?onto the capsula of the apex (Group A), meanwhile,the second group received periprostatic nerve block (Group B) besides basal local apical periprostate?infiltration anesthesia . Intraoperative and postoperative adverse events as well as complications were recorded detailed to evaluate the safety of the two anesthesia methods. Pain evaluation during anaesthetic and biopsy was explained to the patients, and this assessment was performed using an 10-point linear visual analog scale（VAS）. Results：There were no serious adverse events associated with anesthesia during biopsy. The heart rate and blood pressure exhibited mild fluctuation during the operation and showed no significant difference between two groups (P>0.05). Meanwhile, there was no significant difference in VAS scores between two groups during anesthesia (P>0.05). A statistically significant difference was determined in terms of VAS between group A and B during biopsy(P<0.05), PPNB produced superior pain control than TPPB during sampling. Conclusions：The PPNB is a safe and effective analgesic method during transperineal prostate biopsy, showing the better analgesic efficacy than local?anesthesia?onto the capsula of the apex, which is worthy of clinical application.