OBJECTIVE To measure prostate needle biopsy (PNB)-associated complications and place of treatment: inpatient hospitalization and outpatient treatment. An electronic medical record (EMR) data query is compared to a patient questionnaire survey. MATERIALS AND METHODS A total of 2410 patients underwent 2588 biopsies and were evaluated for PNB-associated complications. Two approaches were used: (1) EMR analysis based on International Classification of Diseases, Ninth Revision, and Current Procedural Terminology coding and chart review; and (2) patient-reported questionnaire and chart review validation. Serious complications were defined as any complication leading to a related hospitalization, visit to the emergency department (ED), urgent care (UC), or doctor's office within 30 days of the biopsy. RESULTS The EMR study revealed 69 (2.67%) serious complications leading to either hospitalization or treatment at an ED, UC, or doctor's office. Thirty serious complications led to hospitalization (1.16%), 14 patients (0.54%) were treated at the ED, 1 was managed at a UC (0.04%), and 24 (0.93%) were treated at the doctor's office. Of the 847 (35.1%) questionnaires considered appropriate for analysis, 36 (4.25%) reported treatment in either the hospital, ED, UC, or doctor's office. Nine patients (1.06%) reported being hospitalized within 30 days of the procedure, whereas 27 patients (3.19%) were treated in an outpatient setting, 8 (0.94%) at the ED, 3 (0.35%) at a UC, and 16 (1.89%) at the doctor's office. CONCLUSION Our dual analysis study indicates a slightly greater than 1% incidence of hospitalization due to serious complications following PNB. Serious complications appear to be more frequently managed outside the hospital setting (ED, UC, and doctor's office). (C) 2016 Elsevier Inc.