A man in his 70s with hypertension, hyperlipidemia, type 2 diabetes, chronic kidney disease, and peripheral arterial disease was found to have an elevated prostate-specific antigen (PSA) level of 6.1 μg/L on routine screening. He had no personal or family history of prostate cancer and no concerning findings on digital rectal examination. He was referred to a urologist for further evaluation and underwent an extended (12-core) transrectal prostate biopsy procedure. The procedure was complicated by persistent bleeding, prompting urgent referral to our emergency department.