The incidence of prostate cancer has increased worldwide in the past two decades. Many of the prostate cancers are quite indolent and may never cause problems. Attempts are being made to identify and categorize these patients into low grade, intermediate and high grade prostate cancers for the purpose of treatment. Despite the fact that prostate specific antigen, Gleason score and stage at diagnosis are currently the most reliable indicators of prostate cancer prognosis and tumor aggressiveness, the correlation between PSA levels and Gleason score has not been studied in many centres. A prospective study of 60 patients with histologically proven adenocarcinoma of the prostate seen at the University of Calabar Teaching Hospital (UCTH) was carried out over a 12 month period to find out if there was any correlation between PSA levels and biopsy Gleason scores in these patients. The patients’ ages ranged from 49-95 years with a mean age (± SD) of 67±9.48 years. Most patients in the study were in their sixth decade of life. Nineteen patients (31.7%) were retirees, 12 patients (20%) were manual/agricultural workers. Nine patients (15%) were traders, 3 patients (5%) were factory workers in a cement manufacturing company. Majority of patients were admitted through the Surgical Out-Patient Department (SOPD). Complications that followed the procedure were seen in seven patients (11.7%) and this was mainly bleeding per anum or urethram which either stopped spontaneously or following the insertion of anal pack and/or intramuscular administration of 10mg of vitamin K. Prothrombin time were not done for patients who received vitamin K to see if their response was due to deficiency of vitamin K dependent clotting factors. The mean pre-biopsy PSA level was 43.97±28.87 ng/ml; the highest value being 117ng/ml and the lowest was 0.8ng/ml. At normal PSA level of (0.0 – 4.0) ng/ml, five patients (8.33%) had adenocarcinoma of the prostate. At slightly elevated PSAs of 5 – 9.9 ng/ml, 6 patients (10%) had adenocarcinoma of the prostate gland while 5 patients (8.33%) had adenocarcinoma of the prostate at moderately elevated PSAs of 10 – 19.9 ng/ml. At significantly elevated PSA levels of 20ng/ml and above, 44 patients (73.44%) had adenocarcinoma of the prostate. The mean Gleason grade was 3.3±0.77, with a range of 2-5. A higher number of patients, 32 (53.3%), were in Gleason grade 3 category. Seven patients (11.7%) had well differentiated Gleason grade 2 tumours while 4 patients (6.7%) had poorly differentiated Gleason grade 5 tumours with mean serum PSA levels of 15.4ng/ml and 71.8ng/ml respectively. The mean Gleason score was 6.5±1.40, with a range of 4-9. Five patients had a Gleason score of 4 with a mean serum PSA levels of 9.6ng/ml. Sixteen patients constituted the modal Gleason scores of 6 with a mean serum PSA levels of 28.5 while that for Gleason score of 9 in five patients was 72.1ng/ml. There was positive correlation between pre-biopsy PSA levels and Gleason scores. The Spearman’s rho Correlation Coefficient was 0.345 and this was statistically significant (p=0.006). Among the study population, patients with high Gleason scores showed significantly greater elevation of PSA levels than those with low Gleason scores.