Purpose: The aim of the present study was to evaluate the association between prostate vascularization seen in Doppler ultrasound and histopathological grade (Gleason score) in patients with a diagnosis of prostate cancer. Methods: A Gleason score >7 was the dependent variable and Doppler ultrasound findings (vascular analysis, presence of nodule and prostate weight) were the independent variables. Univariate analysis was performed considering advanced tumors (Gleason >7) as the dependent variable and area of hypervascularization, age and PSA as the independent variables. Multivariate analysis was performed using a binary regression model with the occurrence of advanced tumors (Gleason >7) as the dependent variable. Results: In the univariate analysis, samples with Gleason ≤7 had a lower chance of being hypervascularized (OR: 0.44, 95% CI: 0.29-0.69), whereas those with Gleason scores >7 had a fourfold greater chance of being hypervascularized (OR: 4.136, 95% CI: 2.598-6.554, p<0.001). Moreover, hypervascularized tumors had a 7.4-fold greater chance of having a score >7. Conclusion: The present study reveals an association between tumor hypervascularization detected using Doppler ultrasound and higher Gleason scores (more aggressive tumors), enabling an indirect inference of a worse prognosis for hypervascularized prostatic tumors. These findings should be confirmed in longitudinal studies.