Diffusion-weighted (DW) MR imaging has a great potential in the study of prostate cancer (PCa). We aimed to assess the feasibility and efficacy of intravoxel incoherent motion-kurtosis (IVIM-Kurtosis) model for the differential diagnosis of PCa, benign prostatic hyperplasia and prostatitis (BPH/prostatitis). Thirty-six patients were enrolled and underwent MRI subsequently using in-bore transrectal MR-guided biopsy as the pathological reference. Significant differences were found for D and f values for the differential diagnosis of PCa and BPH/prostatitis, and D median and f median had the highest area under curve. The f, K and D* were correlated with Gleason score (GS) of PCa.