Objective: To explore the application of MR perfusion-weighted imaging (PWI) in the benign and malignant prostate diseases, and evaluate the correlations of PWI features with vascular endothelial growth factor (VEGF) and microvessel density (MVD). Methods: Seventy-four consecutive patients who were diagnosed clinically for the prostate diseases, including forty-four cases with benign prostate hyperplasia and thirty cases with prostatic cancer proved pathologically, were examined by PWI. MVD and VEGF were stained with immunohistochemical methods. Some parameters of PWI, including the steepest slope of signal intensity-time curve (SSmax) and the change in relaxation rate (△R2* peak) at lesions, were analyzed.Correlation analysis was used to determine the relationship between the results of PWI and immunohistochemistry. Results:(1) In the benign prostate hyperplasia (BPH), SSmax and △R2* peak of perfusion curve were 34.2 + 2.9 and 1.49±0.11,respectively; however, in the prostatic cancer (Pca), they were 58.6±4.8 and 3.18 + 0.49 respectively; there were statistical differences (t = 2.16 and 2.31, P ＜ 0.05). (2) The VEGF and MVD expressions of thirty Pca patients were significantly higher than those of forty-four BPH patients (X2 = 28.64, P＜0.01; t = 21.2, P＜0.01). MVD expressions of Pca and BPH groups showed positive associations with VEGF expressions (P＜0.01). On MR perfusion-weighted imaging, SSmax and △R2* peak showed associations with MVD and VEGF expressions (P＜0.01). Conclusion: On MR perfusion-weighted imaging, SSmax and △R2* peak can reflect MVD and VEGF expression levels in the benign and malignant prostate diseases and might be implied the tumor angiogenesis so as to distinguish benign from malignant and provide the important information for the surgeon to diagnose and treat the prostatic diseases.