Background: Diffusion-weighted imaging (DWI) is a main component of multiparametric MRI for prostate cancer detection. Recently, high b value DWI has gained more attention because of its capability for tumor characterization. Objective: To assess based on histopathological findings of transrectal ultrasound (TRUS)-guided prostate biopsy as a reference, an increase in signal intensity of prostatic lesions in comparison with normal background tissue on high b-value diffusion-weighted images could be a sign of malignancy. Material and Methods: Fifty-three consecutive patients retrospectively included in the study. All patients underwent routine TRUS-guided prostate biopsies involving ۱۲ cores after the magnetic resonance imaging (MRI) examinations. In seventeen patients (n =۳۵ lesions), the prostate cancer was histologically confirmed by TRUS-guided prostate biopsy. The biopsy results of other patients were negative. Signal intensities on the high b-value (۱۶۰۰ s/mm۲) images of the peripheral zone, the central gland, and the defined lesions were evaluated using region of interest-based measurements. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for prostate cancer detection using signal intensity of high b value diffusion-weighted images were calculated. Results: In the patients with confirmed prostate cancer, fourteen had visually increased SI on the high b-value images. The SI of lesions for these patients was higher than the SI of peripheral zone (۲۲±۱۸%) or central gland (۳۱±۲۰%). In patients with a negative biopsy, eight had visually increased SI on the high b-value images. The SI of lesions for these patients was ۲۳±۲۱% and ۳۵±۱۸% higher than the SI in the peripheral zone and the central gland, respectively. The sensitivity, specificity, PPV, and NPV for prostate cancer using SI of high b value DWI were ۷۱, ۸۷, ۶۲, and ۸۷ %, respectively. Conclusion: Visually increased SI on the high b-value images can be an indication of malignancy, although some benign lesions also show this increase in signal intensity.