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Prostatic needle biopsies from 142 patients were studied: 61 cases were “benign”, 19 atypical small acinar proliferation, 31 high-grade prostatic intraepithelial neoplasia, and 31 adenocarcinoma. Using univariate analysis of 46 previously described morphological features, 16 variables were selected, which were followed by multivariate discriminant analysis. Of these parameters, seven (glandular fusion, crystalloids, nucleolomegaly, papillary architecture, visibility of basal cell layer, areas of normal luminal cell nucleus/cytoplasm ratio and areas of high luminal cell nucleus/cytoplasm ratio) remained significant in discriminating the groups. Multivariate analysis selected a small panel of histological features as those most helpful in the differential diagnosis of proliferative lesions in prostate biopsies.