Benign prostatic hyperplasia (BPH) is a common condition in men, increasing with age and often associated with lower urinary tract symptoms (LUTS) and impairment of quality of life of patients. Many epidemiological and clinical studies were carried out to identify the natural history of BPH and risk factors for its progression defined as acute urinary retention and the need for surgery. These studies not only showed that BPH is usually a chronic and progressive condition but also identified age, prostate volume, prostate-specific antigen (PSA) and LUTS as risk factors for its progression. Probability of BPH progression increases with more advanced age, higher prostate volume, higher PSA, and severe LUTS (i.e. high symptom score). Although these risk factors are reasonably effective in risk categorization, they are unable to predict BPH progression or failure of conservative management in a man with BPH accurately. Effective tools in which all potential factors for progression are included are needed for more accurate prediction of BPH progression. Recent evidence regarding the attempts for constructing a “BPH nomogram” is noteworthy. Although currently there is no validated nomograms for prediction of BPH progression which is clinically useful for all men with BPH, ongoing studies are promising to provide a useful tool in the near future.