Objective: Design refinement and validation with simulated physical prostates of a planning, guidance, and feedback system for visualizing prostate biopsy in 3D perspective. Methods: A visualized prostate biopsy system (vPBx) using electromagnetic  tracking of a transrectal ultrasound (TRUS) probe, a biopsy device, and a urinary catheter placed inside the patient’s prostate was refined and integrated as a reversible retrofit to a Flex Focus 400 ultrasound machine (BK Medical). The system was verified using simulated physical prostates with 12 0.065 ml (2.5 mm radius) spheres, arranged in a double sextant template, registered to a virtual model of the prostate and used to distinguish hits and misses. Systematic prostate biopsy (sPBx) was performed on simulated prostates using the vPBx as a retrofit to the TRUS machine. Results: The vPBx system enabled an inexperienced user to sample the sPBx template locations with a template deviation below 2.5 mm. Conclusion: An electromagnetic guidance system was refined, retrofitted with a Flex Focus 400 machine and a side-cut biopsy device (Max-Core Disposable Core Biopsy Instrument; Bard) and successfully validated with simulated physical prostates. Significance: If validated with patients, the vPBx system has the potential to reduce prostate biopsy false negatives, which may lead to earlier diagnosis of clinically significant prostate cancer and improved 10-year mortality in high risk prostate cancer patients.