Background: Prostate cancer (PCa) is the most common cancer in men, and early detection plays a critical role in improving patient outcomes. Multiparametric magnetic resonance imaging (mpMRI), with the PI-RADS scoring system, has emerged as a valuable tool for the diagnosis and localization of PCa. This study aims to correlate mpMRI findings with histopathological diagnoses of prostate cancer. Methods: A total of 130 patients suspected of having prostate cancer were included in this study, conducted between 1st July 2019 and 30th June 2020 at Bangha Bandhu Sheikh Mujib Medical University (BSMMU), Dhaka. All patients underwent mpMRI, and PI-RADS scores were assigned. The histopathological diagnoses were made based on biopsy results. Data analysis was performed using SPSS version 22. Results: Among the 130 patients, 75 (57.7%) were diagnosed with prostatic adenocarcinoma, 40 (30.8%) with benign prostatic hyperplasia (BPH), and 15 (11.5%) with high-grade prostatic intraepithelial neoplasia (HGPIN). PSA levels showed that 45 (34.6%) patients had levels greater than 20 ng/mL, indicating high-risk. Regarding PI-RADS scores, 45 (34.6%) patients had PI-RADS 4, and 40 (30.8%) had PI-RADS 5, both strongly associated with malignancy. Conclusion: Our study supports mpMRI as a reliable and non-invasive imaging modality for detecting prostate cancer, especially in patients with higher PI-RADS scores. The strong correlation between mpMRI findings and histopathological diagnoses underscores its role in early detection and targeted biopsy.