Lower urinary tract symptoms suggestive of BPH are frequently encountered in aging men. Surgery is recommended for patients who are moderately to severe bothered by their symptoms and refractory to drug treatment. Transurethral resection of the prostate (TURP) remains a widely applied gold standard therapy. It provides a consistent, long lasting, high level of improvements in symptoms, quality of life and peak urine flow rate. In recent years, several new surgical procedures which use various energy sources for resection, ablation, or vaporization of the prostate have been developed. The most accepted minimally invasive surgical treatments alternative to conventional method are transurethral microwave thermotherapy (TUMT), transurethral needle ablation (TUNA), laser prostatectomy. Minimally invasive surgical treatment has lower morbidity but there are few long term randomized controlled studies about them, so TURP still accepted as the standard therapy in urologic guidelines. Although the short-term results demonstrate the benefits of the minimal invasive surgical treatments, multi-centered randomized studies are needed to assess the long-term durability.