The unexpected high incidence of carcinoma of the prostate (up to 46 per cent.) is stressed. There is no clinical method of diagnosing an early cancer. Cancer usually starts in the posterior surface of the prostate first (in 75 per cent.). Of the three surgical methods applied to the enlarged prostate, the suprapubic has the highest mortality, and the indications for the transurethral resection method are too limited. Perineal prostatectomy is advocated because of its very low mortality, quick recovery and especially because it is directed towards the posterior surface of the prostate where carcinoma first appears. Where necessary the radical elimination of the malignant growth, including prostatic capsule, can be applied through the perineal. approach.