Despite proven efficacy, antimuscarinics are not frequently used for treating lower urinary tract symptoms in adult men, due to the perception of an increased risk of acute urinary retention (AUR). Men treated with α-blockers, 5α-reductase inhibitors, or their combinations have lower AUR incidence rates than the general symptomatic population. In the selected study population in this review (men with post-void residuals ≤200 mL), the risk of AUR with antimuscarinics with and/or without α-blockers may be increased during short-term treatment, but if patients do not develop AUR in the first 3 months, their subsequent risk is lower than in the untreated, symptomatic population.