Transrectal ultrasound (TRUS) guided 12 core biopsy of prostate has a sensitivity of 39-52%. We prospectively evaluated the role of DWI in guiding MRI-TRUS fusion biopsy. MRI was performed on a 3 Tesla system. PIRAD score was assigned and PIRAD 3-5 score were subjected to targeted fusion biopsy using the Artemis device along with standard 12 core biopsies. Targeted biopsy detected a higher number (93%) of clinically significant cancers and 71% cancers were upgraded to significant cancer on targeted biopsy. Fusion biopsies guided by DWI thus provide incremental information over standard TRUS biopsies in the diagnosis of significant prostate cancer.