Objective: To evaluate the clinical significance of clinical staging and magnetic resonance imaging (MRI) staging for prostate cancer before radical prostatectomy. Methods: Thirty-two patients with organ confined prostate cancer were reviewed to assess the accuracy of clinical staging and MRI staging to correlate with pathological staging results after radical prostatectomy. Results: 33.3% (10/30) prostate cancer patients with staging C and 3.3% (1/30) prostate cancer patients with staging D were diagnosed by pathology after radical prostatectomy in 30 patients with prostate cancer with clinical staging B, and 36.7% (11/30) under staging; Only one patient was over staging in clinical staging C. 19.1% (4/21) prostate cancer patients with staging C were diagnosed in 21 patients with prostate cancer and under staging with MRI staging B; 11.1% (1/9) was over staging with MRI staging C. The clinical staging and MRI staging had more correlation with pathological staging results (P=0.002), and PPV of the organ confined prostate cancer by clinical staging and MRI staging were 63.3% and 80.9% respectively, and NPV of nonorgan confined prostate cancer by clinical staging and MRI staging were 50% and 88.9% respectively. MRI staging was more specificity and accuracy than that of clinical staging to predict pathological staging results before radical prostatectomy (P=0.023). Conclusion: The MRI staging was more accuracy than that of clinical staging to predict pathological staging results in organ confined and nonorgan confined prostate cancer before radical prostatectomy.