Management of benign prostatic hyperplasia (BPH) is rapidly changing. Established surgical procedures are being replaced by minimally invasive modalities such as electrovaporization and transurethral needle ablation. Improved understanding of pathophysiology and developments in molecular biology has provided drugs for alleviating the symptoms of prostatic enlargement. Currently, medical therapy is the first-line treatment modality in the management of BPH. There are two types of medical treatment available: ⍺-adrenoceptor-blockers and 5-⍺-reductase inhibitors. Alpha-blockers relieve the dynamic component of obstruction whereas 5-⍺-reductase inhibitors relieve the mechanical component of obstruction. At present, ⍺-blockers are used most frequently. However, they do have significant cardiovascular side effects. More uroselective ⍺-blockers have recently become available and may reduce the risk of cardiovascular side effects. This review summarizes relevant literature on the use of ⍺-blockers in the treatment of BPH.