A 58 years man was submitted to a sextant echo-guided transrectal prostate biopsy. Three weeks later he started complaining of lower abdominal and urinary tract symptoms. Abdominal ultrasound and 3D contrast enhanced CT detected an ovular shaped and capsulated 140 cc volume mass into the peritoneum compressing the bladder. Cytology evaluation showed only haemorrhagic content. After the mass evacuation all the symptoms referred, disappeared. Anyway a hematoma into the peritoneum following a transrectal echo-guided prostate biopsy should represent a unique entity. In fact, this is considered a safe procedure in which generally mild complications occur and they stop spontaneously.

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