Reporting prostate MRI may be complex and prone to subjective interpretation. In 2012 the Prostate Imaging Reporting and Data System (PI-RADS) was introduced. The aims of PI-RADS were to provide minimal requirements for high-quality image acquisition, to standardize reporting, to simplify interpretation, to reduce inter-observer variability and to improve the accuracy of detecting clinically significant prostate cancer. In this lecture it is demonstrated that PI-RADS does not (yet) achieve these goals successfully and that other prostate MRI scoring systems show similar diagnostic performance. PI-RADS has its merits but requires further refinements.