The invention provides a prostate activity appearance model establishing method based on a TURS image, and belongs to the technical field of image processing. The method comprises the following steps: firstly, acquiring prostate 3D MR and TRUS image data, marking shape feature points in the image data, and carrying out shape coordinate alignment by adopting a Protein analysis method; secondly, a principal component method is adopted to carry out dimension reduction on data, features are analyzed, and texture information is obtained through triangulation; and finally, performing feature analysis on the image texture by using a principal component analysis method, establishing a shape texture combination model, and performing parameter solution and optimization on the combination model. According to the method, the shape and appearance change characteristics of the prostate glands are considered, the front AAM model is established on the basis of the TRUS training set images of the prostate glands and serves as the basis of image segmentation positioning, and real-time accurate segmentation of the 3D MR and TRUS images can be achieved.