Recent developments in multiparametric MRI and MRI‐targeted biopsy have made it possible to detect clinically significant cancers more accurately and efficiently than ever before. Furthermore, software that enables easy MRI/US image fusion has been developed and is already available on the market, and this has provided a tailwind for the spread of MRI‐based prostate cancer diagnostic strategies. Such precise diagnosis of prostate cancer localization is essential for highly accurate focal therapy. In addition, a recent large‐scale study applying MRI to community screening for prostate cancer has reported its usefulness. By contrast, concerns about overdiagnosis and overtreatment, the existence of inter‐reader variability in MRI diagnosis, and issues with current MRI‐targeted biopsy have emerged. In this article, we review the development of multiparametric MRI and MRI‐targeted biopsy to date and the current issues and discuss future directions.