Benign prostatic hyperplasia (BPH) is a common urological condition affecting elderly men worldwide. In 2021, there were 112,502 (95% UI: 88,131.8-142,634.2) thousand prevalent cases globally, compared to 50,705.8 (95% UI: 38,735.5-65,693.4) thousand cases in 1990, representing a 122% increase. Over the past 30 years, the burden of BPH in low and low-middle socio-demographic index (SDI) regions have shown an upward trend and is projected to continue increasing over the next 15 years. Middle-SDI regions are facing the heaviest absolute burden of BPH. Despite declining prevalence, incidence, and disability-adjusted life years rates in high-middle SDI regions, the absolute BPH burden remains high, ranking second among the five SDI regions. In contrast, high-SDI regions exhibit a relatively low and stable BPH burden, though significant variations exist even among countries within the high-SDI category. Additionally, the global 65-69 age group bears the highest burden, with the 40-44 and 80+ age groups showing increasing trends. The burden of BPH varies significantly across regions, socioeconomic statuses, and countries, yet the absolute burden is generally increasing. The substantial regional differences in BPH burden underscore its widespread impact and potential controllability, indicating the need for more targeted healthcare efforts to address the growing BPH burden.