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Intraductal carcinoma of the prostate (IDC-P) is an aggreSSive pathological pattern of prostate cancer (PCa).We investigated the association of IDC-P in prostate biopsy (PBx) with several pathological features after radical prostatectomy (RP) and its prognostic value in high-risk PCa.A total of 418 patients with high-risk PCa after RP were included in this study.IDC-P and its architectural patterns were identified according to the 2016 World Health Organization Classification.Chi-squared test and logistic regression were used to investigate the correlation between IDC-P and post-RP pathological features.Kaplan-Meier curves and Cox regression were applied to explore the prognostic value of IDC-P.IDC-P was identified in PBx in 36/418 (8.6％) patients.Logistic regression indicated that IDC-P in PBx was independently associated with several pathological features of RP,including Gleason score 8-10 (P＜ 0.001),seminal vesicular invasion (P＜ 0.001),and pathological T (pT) 3a (P=0.043).Patients with IDC-P in PBx manifested poorer biochemical-free survival (BFS) than those without IDC-P (37.47 months vs not reached,P ＜ 0.001).The addition of IDC-P in several prognostic nomograms could improve the predictive accuracy of these tools.We conclude that IDC-P in PBx is positively associated with several aggressive pathological features after RP in high-risk PCa.In addition,IDC-P in PBx could effectively predict the BFS of high-risk PCa patients after RP.