Complications following prostate needle biopsy requiring hospital admission or emergency department visits - experience from 1000 consecutive cases. 
• To review a contemporary cohort of patients undergoing a transrectal ultrasound-guided prostate needle biopsy (TRUS PNBx) at a single centre to determine the incidence of major complications necessitating hospital admission or emergency department (ED) visits. •  The charts of 1000 consecutive patients undergoing TRUS PNBx were reviewed. •  All patients received peri-procedural antibiotic prophylaxis with either ciprofloxacin or co-trimoxazole. •  Hospital admission and ED visits within 30 days of the procedure were identified for indication, management and outcome. •  Patient comorbidities and biopsy characteristics were reviewed for association with complications. •  Of the 1000 patients, 25 (2.5%) had post-biopsy complications requiring hospital admission or an ED visit. •  Indications included twelve patients (1.2%) with urosepsis, eight (0.8%) with acute urinary retention requiring urethral catheterization, four (0.4%) with gross haematuria requiring bladder irrigation for <24 h, and one (0.1%) with a transient ischaemia attack 1 day after biopsy. •  Patients with urosepsis had an average hospitalization of 5 days, and 75% carried quinolone-resistant Escherichia coli organisms. •  All patients with urinary retention had catheters removed within 10 days.  No patients with haematuria required a blood transfusion. •  No demographic or biopsy variables were particularly associated with development of a post-procedure complication. •  In this large contemporary series of TRUS PNBx, we observed a 2.5% rate of major complications requiring hospital admission or an ED visit. •  No clinical or biopsy variables were directly associated with development of complications. •  These data may be valuable when counselling patients before biopsy.