Introduction: We aimed to evaluate the application of the Visual Prostate Symptoms Score (VPSS) in older men with benign prostatic hyperplasia (BPH), highlighting the question of force stream. Methods: A cross-sectional study was conducted with 54 older men diagnosed with BPH at a teaching hospital between September 2023 and September 2024. The VPSS and IPSS were completed without assitance. The uroflowmetry parameters and post-void residual (PVR) were recorded. Results: The mean age was 76.2 ± 15.7 years. Regarding educational level, one-third of the patients went to secondary school or lower. Mean Qmax was 7.2 ± 2.3 mL/s. The mean total IPSS was 18.5 ± 6.9, while the mean VPSS was 9.2 ± 3.5. Most patients realized that the VPSS is easier to understand than the IPSS. Correlation analysis showed that the VPSS was highly correlated with the IPSS (r = 0.79, p = 0.001). Each category of the VPSS, including force stream, frequency, and nocturia, was correlated with the paired category in the IPSS, wherein the force stream had the highest correlation coefficient. The VPSS force stream was correlated with uroflowmetry parameters. Conclusion: The VPSS is a useful tool for assessing LUTS and is applicable to elderly men. The question of force stream is well correlated with equivalent question in VPSS and uroflowmetry parameters.