Introduction: Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are the most common diseases of the prostate; however, their interaction is not well studied. Historically, elucidating the epidemiology of BPH has been complicated by the lack of a uniform definition of clinical BPH, quantitative instruments for assessing the severity of lower urinary tract symptoms, and a noninvasive and accurate method for measuring both prostate volume and bladder outlet obstruction. Objectives of the study: The main objectives of the study is to find the relationship of prostate volume with incidence of prostate cancer. Methodology of the study: This cross sectional study was conducted at RMC during June 2019 to December 2019. For each patient prior to performing a warranted prostate biopsy, a complete history was collected and physical examination was performed. The prostate volume for each patient was estimated by DRE and confirmed by transrectal ultrasound (TRUS). Patients who underwent prior biopsies or prior surgeries were excluded from our study. Results: The study group comprised of 100 patients 72 (93.5%) were initial steroid resistant and 28 were late non-responders. Gender distribution showed 49 (63.6%) males and 28 (36.4%) females with a ratio of 1.75. We then determined the Gleason scores for prostates with a volume of <35 and >65 cc. Of the 110 patients testing positive on biopsy with a volume of <35 cc, 10 patients (9.09%) had a Gleason score of ≥8. Of the 27 patients testing positive on biopsy with a volume of >65 cc, 1 patient (3.7%) had a Gleason score of ≥8. Age range of patients was 1-15 years with a mean of 8.11 +3.58 years. Conclusion: It is concluded that there is an inverse association of prostate volume with the incidence and biological aggressiveness of PCa. Data from this study and the outlined discussion should encourage other clinicians and investigators to further explore the relationship between prostate volume and the incidence and aggressiveness of PCa, to further investigate this phenomenon.