Objective To explore the diagnostic value of magnetic resonance spectroscopy (MRS) combined with conventional multi-parameter magnetic resonance imaging (MP-MRI) in prostate cancer (PCa). Methods 104 patients with suspected PCa were treated as the research objects. MRS combined with MP- MRI examinations were given to all patients, the diagnostic value and Cho/Cit and (Cho+Cre)/Cit levels of MRS combined with MP-MRI and MP-MRI were compared. Results The pathological results showed that 52 patients had prostate hyperplasia and 52 patients had PCa. The specificity (84.62%) and sensitivity (92.31%) of MRS combined with MP-MRI were higher than that of MP-MRI (63.46%) and (76.92%), (P<0.05); PCa group choline (Cho)/citrate Cit and ［Cho+creatine (Cre)］/Cit levels were higher than those in the prostate hyperplasia group (P<0.05). Conclusions Cho and Cit are highly expressed in PCa patients. Using MRS combined with MP-MRI to check PCa can improve the diagnostic value.